Coping Mechanisms Utilized by Individuals With Drug Addiction in Overcoming Challenges During the Recovery Process: A Qualitative Meta-synthesis / 예방의학회지

Objectives@#Recovery from drug addiction often poses challenges for the recovering person. The coping mechanisms employed by these individuals to resist temptations and manage stress play a key role in the healing process. This study was conducted to explore the coping strategies or techniques that individuals with addiction use to handle stress and temptation while undergoing treatment. @*Methods@#A qualitative meta-synthesis approach was utilized to critically evaluate relevant qualitative research. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines were used for article selection, with these standards applied to 4 academic databases: Scopus, PubMed, ProQuest, and CINAHL. The present review included studies published between 2014 and 2023, selected based on pre-established inclusion criteria. The quality of the studies was assessed using the Critical Appraisal Skills Programme Qualitative Studies Checklist. This review was registered with the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42024497789. @*Results@#The analysis of 13 qualifying qualitative articles revealed 5 major themes illustrating the coping mechanisms employed in the pursuit of recovery by individuals who use drugs. These themes include seeking social support, as well as psychological coping strategies, spiritual experiences, professional interventions, and the enhancement of awareness. @*Conclusions@#Among individuals with drug addiction, coping mechanisms are crucial for resisting stress and temptations throughout the recovery process. Healthcare professionals, as medical specialists, can establish more thorough and effective plans to support these patients on their path to recovery.

Diagnosis and Management of Hepatic Hydrothorax / 대한소화기학회지

Hepatic hydrothorax is a pleural effusion (typically ≥500 mL) that develops in patients with cirrhosis and/or portal hypertension in the absence of other causes. In most cases, hepatic hydrothorax is seen in patients with ascites. However, ascites is not always found at diagnosis and is not clinically detected in 20% of patients with hepatic hydrothorax. Some patients have no symptoms and incidental findings on radiologic examination lead to the diagnosis of the condition. In the majority of cases, the patients present with symptoms such as dyspnea at rest, cough, nausea, and pleuritic chest pain. The diagnosis of hepatic hydrothorax is based on clinical manifestations, radiological features, and thoracocentesis to exclude other etiologies such as infection (parapneumonic effusion, tuberculosis), malignancy (lymphoma, adenocarcinoma) and chylothorax. The management strategy involves a stepwise approach of one or more of the following: Reducing ascitic fluid production, preventing fluid transfer to the pleural space, fluid drainage from the pleural cavity, pleurodesis (obliteration of the pleural cavity), and liver transplantation. The complications of hepatic hydrothorax are associated with significant morbidity and mortality. The complication that causes the highest morbidity and mortality is spontaneous bacterial empyema (also called spontaneous bacterial pleuritis).

Evidence of Placental Villous Inflammation and Apoptosis in Third-Trimester Symptomatic SARS-CoV-2 Maternal Infection

Purpose@#In view of conflicting reports on the ability of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) to infect placental tissue, this study aimed to further evaluate the impact of inflammation and placental damage from symptomatic thirdtrimester maternal COVID-19 infection. @*Materials and Methods@#This case-control study included 32 placenta samples each from symptomatic COVID-19 pregnancy and normal non-COVID-19 pregnancy. The villous placental area’s inflammatory expression [angiotensin converting enzyme-2 (ACE-2), transmembrane protease serine-2 (TMPRSS2), interferon-γ (IFN-γ), interleukin-6 (IL-6), and SARS-CoV-2 spike protein] and apoptotic rate were examined using immunohistochemistry and Terminal deoxynucleotidyl transferase dUTP Nick- End Labeling (TUNEL) assay. Comparison and correlation analysis were used based on COVID-19 infection, placental SARS-CoV-2 spike protein evidence, and maternal severity status. @*Results@#Higher expressions of TMPRSS2, IFN-γ, and trophoblast apoptotic rate were observed in the COVID-19 group (p0.05). Additionally, SARS-CoV-2 spike protein was detected in 8 (25%) placental samples of COVID-19 pregnancy. COVID-19 subgroup analysis revealed increased IFN-γ, trophoblast, and stromal apoptosis (p<0.01). Moreover, the results of the current study revealed no correlation between maternal COVID-19 severity and placental inflammation as well as the apoptotic process. @*Conclusion@#The presence of SARS-CoV-2 spike protein as well as altered inflammatory and apoptotic processes may indicate the presence of placental disturbance in third-trimester maternal COVID-19 infection. The lack of correlation between placental disruption and maternal severity status suggests the need for more research to understand the infection process and any potential long-term impacts on all offsprings born to COVID-19-infected pregnant women.

Heart rate variability analysis to investigate autonomic nervous system activity among the three premature ventricular complex circadian types: An observational study

Background and Objective@#Premature ventricular complex (PVC) burden exhibits one of three circadian types, classified as fast-type, slow-type, and independent-type PVC. It is unknown whether PVC circadian types have different heart rate variability (HRV) parameter values. Therefore, this study aimed to evaluate differences in HRV circadian rhythm among fast-, slow-, and independent-type PVC. @*Methods@#This cross-sectional observational study consecutively recruited 65 idiopathic PVC subjects (23 fast-, 20 slow-, and 22 independent-type) as well as five control subjects. Each subject underwent a 24-hour Holter to examine PVC burden and HRV. HRV analysis included components that primarily reflect global, parasympathetic, and sympathetic activities. Repeated measures analysis of variance was used to compare differences in HRV circadian rhythm by PVC type. Results. The average PVC burden was 15.7%, 8.4%, and 13.6% in fast-, slow-, and independent-type idiopathic PVC subjects, respectively. Global, parasympathetic nervous system, and sympathetic nervous system HRV parameters were significantly lower in independenttype PVC versus fast- and slow-type PVC throughout the day and night. Furthermore, we unexpectedly found that tendency towards sympathetic activity dominance during nighttime was only in independent-type PVC.@*Conclusion@#The HRV parameters are reduced in patients with independent-type PVC compared to fast- and slowtype PVC. Future research is warranted to determine possible differences in the prognosis between the three PVC types.

Supervision outcome of professional education of school counselors in-service training

Professionalization efforts for school counselors through professional education, which are strengthened by supervision during the educational process, aim to improve their clinical and multicultural competence, which is essential in providing guidance and counseling services in schools. Using a quantitative approach and the Supervision Outcome Scale analyzed using the Rasch model, this study examined supervision conducted by university and field supervisors of internship counselors. The results showed that supervision outcomes were in the moderate category in competency development. However, a closer look revealed variations in the level of difficulty of item agreement based on supervisors' perspectives. The study also highlighted challenges in achieving maximum supervision outcomes, including limited internship time. While this study provides important insights into supervision outcomes, limitations such as using a quantitative approach may only partially capture the complexity of the supervision process. Recommendations for future research include using qualitative methods, exploring other factors that reveal supervision outcomes, and researching the impact of internship duration on counselor competency development.

Los esfuerzos de profesionalización para los consejeros escolares a través de la educación profesional, que se refuerzan con la supervisión durante el proceso educativo, tienen como objetivo mejorar su competencia clínica y multicultural, lo cual es esencial para proporcionar servicios de orientación y consejería en las escuelas. Utilizando un enfoque cuantitativo y la escala de resultados de supervisión analizada con el modelo de Rasch, este estudio examinó la supervisión realizada por supervisores universitarios y de campo de los consejeros en prácticas. Los resultados mostraron que la supervisión estaba en la categoría moderada en el desarrollo de competencias. Sin embargo, un análisis más detallado reveló variaciones en el nivel de dificultad para la concordancia de ítems basados en las perspectivas de los supervisores. El estudio también destacó desafíos para lograr resultados óptimos de supervisión, incluyendo el tiempo limitado de prácticas. Aunque este estudio proporciona perspectivas importantes sobre los resultados de la supervisión, limitaciones como el uso de un enfoque cuantitativo pueden captar solo parcialmente la complejidad del proceso de supervisión. Las recomendaciones para investigaciones futuras incluyen el uso de métodos cualitativos, la exploración de otros factores que revelen resultados de la supervisión y la investigación del impacto de la duración de las prácticas en el desarrollo de la competencia de los consejeros.

Os esforços de profissionalização para conselheiros escolares por meio da educação profissional, que são fortalecidos com a supervisão durante o processo educativo, visam melhorar a competência clínica e multicultural, o que é essencial na prestação de serviços de orientação e aconselhamento nas escolas. Utilizando uma abordagem quantitativa e a escala de resultados de supervisão analisada com o modelo de Rasch, este estudo examinou a supervisão realizada por supervisores universitários e de campo para conselheiros em estágio. Os resultados mostraram que os resultados da supervisão estavam na categoria moderada no desenvolvimento de competências. No entanto, uma análise mais detalhada revelou variações no nível de dificuldade de concordância dos itens com base nas perspectivas dos supervisores. O estudo também destacou desafios na obtenção de resultados ótimos de supervisão, incluindo o tempo limitado de estágio. Embora este estudo forneça conclusões importantes sobre os resultados da supervisão, limitações, como o uso de uma abordagem quantitativa, podem capturar apenas parcialmente a complexidade do processo de supervisão. Recomendações para pesquisas futuras incluem o uso de métodos qualitativos, explorar outros fatores que revelem resultados de supervisão e pesquisar o impacto da duração do estágio no desenvolvimento da competência dos conselheiros.

Study on the role of nano antibacterial materials in orthodontics (a review) / Estudo sobre o papel dos materiais nanoantibacterianos na ortodontia

Nanoparticles (NPs) are insoluble particles with a diameter of fewer than 100 nanometers. Two main methods have been utilized in orthodontic therapy to avoid microbial adherence or enamel demineralization. Certain NPs are included in orthodontic adhesives or acrylic resins (fluorohydroxyapatite, fluorapatite, hydroxyapatite, SiO2, TiO2, silver, nanofillers), and NPs (i.e., a thin layer of nitrogen-doped TiO2 on the bracket surfaces) are coated on the surfaces of orthodontic equipment. Although using NPs in orthodontics may open up modern facilities, prior research looked at antibacterial or physical characteristics for a limited period of time, ranging from one day to several weeks, and the limits of in vitro studies must be understood. The long-term effectiveness of nanotechnology-based orthodontic materials has not yet been conclusively confirmed and needs further study, as well as potential safety concerns (toxic effects) associated with NP size.

Nanopartículas (NPs) são partículas insolúveis com diâmetro inferior a 100 nanômetros. Dois métodos principais têm sido utilizados na terapia ortodôntica para evitar a aderência microbiana ou a desmineralização do esmalte: NPs são incluídas em adesivos ortodônticos ou resinas acrílicas (fluoro-hidroxiapatita, fluorapatita, hidroxiapatita, SiO2, TiO2, prata, nanopreenchimentos) e NPs são revestidas nas superfícies de equipamentos ortodônticos, ou seja, uma camada fina de TiO2 dopado com nitrogênio nas superfícies do braquete. Embora o uso de NPs em ortodontia possa tornar acessível modernos recursos, pesquisas anteriores analisaram as características antibacterianas ou físicas por um período limitado de tempo, variando de 24 horas a várias semanas, por isso devem ser compreendidos os limites dos estudos in vitro. A eficácia de longo prazo de materiais ortodônticos com base em nanotecnologia ainda não foi confirmada de forma conclusiva, o que exige mais estudos, bem como potenciais preocupações de segurança (efeitos tóxicos) associadas ao tamanho da NP.

Study on the role of nano antibacterial materials in orthodontics (a review)

Abstract Nanoparticles (NPs) are insoluble particles with a diameter of fewer than 100 nanometers. Two main methods have been utilized in orthodontic therapy to avoid microbial adherence or enamel demineralization. Certain NPs are included in orthodontic adhesives or acrylic resins (fluorohydroxyapatite, fluorapatite, hydroxyapatite, SiO2, TiO2, silver, nanofillers), and NPs (i.e., a thin layer of nitrogen-doped TiO2 on the bracket surfaces) are coated on the surfaces of orthodontic equipment. Although using NPs in orthodontics may open up modern facilities, prior research looked at antibacterial or physical characteristics for a limited period of time, ranging from one day to several weeks, and the limits of in vitro studies must be understood. The long-term effectiveness of nanotechnology-based orthodontic materials has not yet been conclusively confirmed and needs further study, as well as potential safety concerns (toxic effects) associated with NP size.

Resumo Nanopartículas (NPs) são partículas insolúveis com diâmetro inferior a 100 nanômetros. Dois métodos principais têm sido utilizados na terapia ortodôntica para evitar a aderência microbiana ou a desmineralização do esmalte: NPs são incluídas em adesivos ortodônticos ou resinas acrílicas (fluoro-hidroxiapatita, fluorapatita, hidroxiapatita, SiO2, TiO2, prata, nanopreenchimentos) e NPs são revestidas nas superfícies de equipamentos ortodônticos, ou seja, uma camada fina de TiO2 dopado com nitrogênio nas superfícies do braquete. Embora o uso de NPs em ortodontia possa tornar acessível modernos recursos, pesquisas anteriores analisaram as características antibacterianas ou físicas por um período limitado de tempo, variando de 24 horas a várias semanas, por isso devem ser compreendidos os limites dos estudos in vitro. A eficácia de longo prazo de materiais ortodônticos com base em nanotecnologia ainda não foi confirmada de forma conclusiva, o que exige mais estudos, bem como potenciais preocupações de segurança (efeitos tóxicos) associadas ao tamanho da NP.

Association of acute hyperglycemia and diabetes mellitus with Platelet-derived Microparticle (PDMP) levels during acute myocardial infarction / Journal of the ASEAN Federation of Endocrine Societies

Objectives@#This research aims to investigate whether there is an association between acute hyperglycemia and diabetes mellitus and the amount of circulating platelet-derived microparticles (PDMPs) during acute myocardial infarction (AMI) initial episode.@*Methodology@#This was a cross-sectional study. Subjects were AMI patients underwent hospitalization. Demography and clinical data were obtained from hospital records. Diabetes mellitus was defined from history of disease, antidiabetic use and/or level of HbA1C ≥6.5%. Levels of HbA1c, admission random and fasting blood glucose levels were measured in hospital laboratory. The PDMPs was measured by flow-cytometry method, by tagging with CD-41 FITC and CD-62 PE markers and threshold size of <1 µm, from venous blood. The circulating PDMPs amount was compared according to glucometabolic state, namely acute hyperglycemia (admission random glucose ≥200 mg/dL and fasting glucose ≥140 mg/dL) and diabetes mellitus. The comparative analysis between group was conducted with Student T tests or Mann-Whitney tests, where applicable.@*Results@#A total of 108 subjects were included and their data analyzed. Circulating PDMPs amount was significantly lower in subjects with admission random glucose ≥200 mg/dL as compared to those with below level (median (interquartile range (IQR)): 2,710.0 (718.0-8,167.0) count/mL vs. 4,452.0 (2,128.5-14,499.8) count/mL, p=0.05) and in subjects with fasting glucose ≥140 mg/dL as compared to those with below level (median (IQR): 2,382.0 (779.0-6,619.0) count/mL vs. 5,972.0 (2,345.7-14,781.3) count/mL, p=0.006). Circulating PDMPs amount was also significantly lower in diabetes mellitus as compared to non diabetic (median (IQR): 2,655.0 (840.0-5,821.0) count/mL vs. 4,562.0 (2,128.5-15,055.8) count/mL; p=0.007).@*Conclusion@#Acute hyperglycemia and diabetes mellitus significantly associated with lower amount of circulating PDMPs during the initial episode of AMI.

Predictors of Adherence to Personal Preventive Behaviors Among Nursing Students Based on Health Belief Model: Cross Sectional Study During the Second Wave of COVID-19 Pandemic in Indonesia

@#Introduction: Personal preventive behaviors was cited as effective strategy to prevent the SARS-CoV-2 transmissions. When vaccine become available, preventive behavior must still be implemented to significantly decreased the COVID-19 infection risk in the emergence of novel SARS-CoV-2 variants of concern with immune escape phenotype. The Health Belief Model (HBM) is the most widely recognized behaviour theory, but its capacity to predict the preventive behaviours have been inconsistent. This study aimed to assess predictors adherence to COVID-19 preventive behaviour among nursing students based on HBM during the second wave of COVID-19 in Indonesia. Methods: An online cross-sectional study was conducted from May to September 2021. Undergraduate nursing students (n=1,413) from 10 universities in Indonesia was recruited using consecutive sampling. Online self-administered questionnaire was used to collect the data. Binary logistic regression was employed to analyse the association between sociodemographic and HBM construct with adherence to preventive behaviors. Results: Most of the students (n=804; 56.9 %) had poor adherence to COVID-19 preventive behaviors, and poor physical distancing identified as the most dominant non-adherence type (n=774; 54.8 %). First year students (AOR=1.313; 95%CI: 1.020-1.690), low perceived susceptibility (AOR=1.530; 95%CI: 1.193-1.962), low perceived severity (AOR= 1.756; 95%CI: 1.337- 2.307), low perceived effectiveness (AOR=1.910; 95%CI: 1.315-2.777), and low self-efficacy (AOR=4.795; 95%CI: 3.566-6.447) significantly associated with poor adherence (p<0.05). Nagelkerke R square value was 0.313 suggesting that the whole model explained 31.3% of variance in adherence. Conclusion: Intervention that targeting health belief model could be useful to increased adherence level to COVID-19 preventive measures among nursing students.

Effectiveness of Blended Learning Competency Test among Nursing Profession Education

@#Introduction: The COVID-19 pandemic has limited social activities in public spaces because transmission originates from physical contact. The impact of activity limitations affects the nursing profession’s practice learning system. The blended learning model is used to achieve the learning process. This study aimed to identify the effect of blended learning on knowledge of competency tests for nursing students at the mental health nursing station. Methods: The study used a quantitative study approach with a quasi-experiment design. The number of respondents based on the calculation of the total sampling amounted to 77 people. It used research data collection with the pre and post-test procedures, which arranged the questions based on the style of competency tests. The data analysis used a parametric Paired T-test. Results: The results showed an effect of blended learning on knowledge of competency test questions for nursing students at the mental health nursing station with a p-value < 0.05. There is an increase in the average knowledge of nursing students before and after the blended learning process. Conclusion: This study provides recommendations for approaches related to methods and evaluation in blended learning in each subject taught at the professional stage.

Density Of Eggs and Larvae of Aedes Spp and the Characteristics of their Larvae Habitat in Endemic Dengue Area of Ternate City

@#Introduction: Dengue Fever (DF) is a disease spread by Aedes spp. caused by dengue virus infection. The study aimed to identify the density of Aedes spp eggs and larvas stages and the characteristics of their habitat in dengue-endemic areas in Ternate City in September-December 2021. Methods: the research was conducted in four dengue-endemic villages in Ternate City, namely Sangaji, Maliaro, Bastiong Karance, and Bastiong Talangame village. In 80 households, egg density was determined by placing 2 ovitraps in each house, one inside and one outside the house. After a week, the filter paper which is a medium mosquito to lay their eggs in the ovitrap was collected, and the ovitrap index value was calculated. The value of the House Index (HI), Container Index (CI), and Breuteu Index (BI) was used to calculate the larval density. The type and materials of the containers were used to assess the parameters of the larval environment. Results: The ovitrap index value in the four villages was categorized as moderate level 3 (27.50% -36.25%). The highest larval density was found in Sangaji Village (HI = 81%), while the lowest was in Bastion Talangame Village (HI = 70%). The highest CI and BI values were found in Bastiong Karance Village (CI=51.5% and BI=190%), and the lowest was in Maliaro Village (CI=37.5% and BI=128%). Density figures in all endemic villages have a high larval density with a value of 8. Conclusion: There was no significant difference (p>0.05) between the types and the materials of containers in each village in Dengue endemic areas. The high density of the egg and larval stage and the information characteristic of habitat Aedes spp. could be considered as basic information for dengue vector control in Ternate City.

Dynamic Self-Determination of Self-Care and Positive Deviance Model for Stunting Prevention in Indonesia

ABSTRACT Objective: To describe the dynamic self-determination of self-care (DSDoSC) and positive deviance (PD) models in changing stunting prevention behavior. Material and Methods: This research is a quasi-experimental study with a sample of 90 mothers taken by purposive sampling. Thirty mothers were given the DSDoSC intervention, 30 were given the PD intervention, and another 30 were in the control group. This research was conducted in July - October 2019. The variables studied were feeding behavior, nurturing behavior, personal hygiene behavior, environmental cleanliness and air sanitation, and behavior seeking health services. To analyze the difference in mother behaviour before and after test, we used Paired t-test. Analysis of Variance (MANOVA) was used to analyze the difference of mother behaviour among groups. The level of significance was p<0.05. Results: The PWD group showed that eating behavior, parenting behavior, personal hygiene behavior, environmental hygiene and water sanitation, and behavior seeking health services had significant numbers. In the DSDoSC group, eating behavior, parenting behavior, environmental hygiene, water sanitation and health service-seeking behavior were significantly (p<0.05). The results of the Manova test showed that there was an effect of PD and DSDoSC on stunting prevention behavior. Conclusion: Self-dynamic for self-care model and the positive deviance model both can change a mother's behavior for the better in feeding, parenting, environmental hygiene, and water sanitation, seeking health services, but not changing behavior about personal hygiene behavior.

First 24-h Sardjito Cardiovascular Intensive Care (SCIENCE) admission risk score to predict mortality in cardiovascular intensive care unit (CICU)

Background and objectives: The application of prognostic scoring systems to identify risk of death within 24 h of CICU admission has significant consequences for clinical decision-making. Previous score of parameters collected after 24 h was considered too late to predict mortality. As a result, we attempted to develop a CICU admission risk score to predict hospital mortality using indicators collected within 24 h. Methods: Data were obtained from SCIENCE registry from January 1, 2021 to December 21, 2021. Outcomes of 657 patients (mean age 58.91 ± 12.8 years) were recorded retrospectively. Demography, risk factors, comorbidities, vital signs, laboratory and echocardiography data at 24-h of patient admitted to CICU were analysed by multivariate logistic regression to create two models of scoring system (probability and cut-off model) to predict in-hospital mortality of any cause. Results: From a total of 657 patients, the hospital mortality was 15%. The significant predictors of mortality were male, acute heart failure, hemodynamic instability, pneumonia, baseline creatinine _x0001_1.5 mg/ dL, TAPSE <17 mm, and the use of mechanical ventilator within first 24-h of CICU admission. Based on Receiver Operating Characteristic (ROC) curve analysis a cut off of _x0001_3 is considered to be a high risk of inhospital mortality (sensitivity 75% and specificity 65%). Conclusion: The initial 24-h SCIENCE admission risk rating system can be used to predict in-hospital mortality in patients admitted to the CICU with a high degree of sensitivity and specificity,

Phenol compound content and antibacterial activity of gaharu leaf extract products (Aquilaria malaccensis)

Gaharu leaf extract produces yield extraction, phenol compound, and antibacterial activity in diverse quantities. The purpose of this research was to investigate the influence of the extraction method and type of solvent on the extractability of the polyphenol component and the antibacterial activity of gaharu leaves. Extraction was done through maceration and Soxhlet methods by using solvents of hexane, ethyl acetate, and ethanol. The extraction result showed that the highest yield value of 18.4% was found on the treatment of a combination of ethanol solvent and Soxhlet method. The total content of phenol and tannin of gaharu leaf extract was in the range of 11.2 to 18.62mg. mL-1 and 12.82 to 13.41%, respectively. Antibacterial activity of gaharu leaf extract on the Gram-positive test of Staphylococcus aureus was higher than that of the Gram-negative test of Escherichia coli having a value of zone of inhibition in the range of 5.33 to 6.33 mm and 4.00 to 5.00 mm, respectively.

Simulation-based training using a novel Surabaya hysterectomy mannequin following video demonstration to improve abdominal hysterectomy skills of obstetrics and gynecology residents during the COVID-19 pandemic in Indonesia: a pre- and post-intervention study / 보건의료교육평가

Purpose@#During the coronavirus disease 2019 (COVID-19) pandemic, the number of abdominal hysterectomy procedures decreased in Indonesia. The existing commercial abdominal hysterectomy simulation model is expensive and difficult to reuse. This study compared residents’ abdominal hysterectomy skills after simulation-based training using the Surabaya hysterectomy mannequin following a video demonstration. @*Methods@#We randomized 3rd- and 4th-year obstetrics and gynecology residents to a video-based group (group 1), a simulation-based group (group 2), and a combination group (group 3). Abdominal hysterectomy skills were compared between before and after the educational intervention. The pre- and post-tests were scored by blinded experts using the validated Objective Structured Assessment of Technical Skills (OSATS) and Global Rating Scale (GRS). @*Results@#A total of 33 residents were included in the pre- and post-tests. The OSATS and GRS mean differences after the intervention were higher in group 3 than in groups 1 and 2 (OSATS: 4.64 [95% CI, 2.90–6.37] vs. 2.55 [95% CI, 2.19–2.90] vs. 3.82 [95% CI, 2.41–5.22], P=0.047; GRS: 10.00 [95% CI, 7.01–12.99] vs. 5.18 [95% CI, 3.99–6.38] vs. 7.18 [95% CI, 6.11–8.26], P=0.006). The 3rd-year residents in group 3 had greater mean differences in OSATS and GRS scores than the 4th-year residents (OSATS: 5.67 [95% CI, 2.88–8.46]; GRS: 12.83 [95% CI, 8.61–17.05] vs. OSATS: 3.40 [95% CI, 0.83–5.97]; GRS: 5.67 [95% CI, 2.80–8.54]). @*Conclusion@#Simulation-based training using the Surabaya hysterectomy mannequin following video demonstration can be a bridge to learning about abdominal hysterectomy for residents who had less surgical experience during the COVID-19 pandemic.

Obstetrics and gynecology residents’ satisfaction and self-confidence after an anal sphincter injury simulation-based workshop in Indonesia: a pre- and post-intervention comparison study / 보건의료교육평가

Purpose@#Obstetric anal sphincter injury is one of the most common complications during delivery. Simulation models with manikins can be used as an effective medical learning method to improve students’ abilities before encountering patients. The present study aimed to describe the development of an anal sphincter injury model and to assess residents’ satisfaction and self-confidence after a perineal repair workshop with an anal sphincter injury simulator in Indonesia. @*Methods@#This was a cross-sectional study with evaluation of outcomes before and after the workshop. We created a silicone-latex simulation anal sphincter injury model. Then, we validated this simulation and used it as a simulation model for the workshop. We asked residents about their satisfaction with repairing anal sphincter injuries using a simulation model and residents’ self-confidence when practicing anal sphincter injury repair. @*Results@#All residents felt the simulation-based workshop was valuable (100%). Most of the scores for the similarity of the simulation model were good (about 8 out of maximum 10). The self-assessment of confidence was measured before and after the workshop. Overall self-confidence increased significantly after the workshop in identifying the external sphincter ani (EAS) (P=0.031), suturing the anal mucosa (P=0.001), suturing the internal sphincter ani (P=0.001), suturing the EAS (P<0.001), and evaluating the sphincter ani tone (P=0.016). @*Conclusion@#The anal sphincter injury simulator improved residents’ self-confidence in identifying the EAS, suturing the anal mucosa, suturing the internal sphincter ani, suturing the EAS, and evaluating sphincter ani tone.

Density Of Eggs and Larvae of Aedes Spp. and the Characteristics of their Larvae Habitat in Endemic Dengue Area In Ternate City

@#Introduction: Dengue Fever (DF) is a disease spread by Aedes spp. caused by dengue virus infection. The study aimed to identify the density of egg and larval Aedes spp. stages and the characteristics of their habitat in dengue-endemic areas in Ternate City in September 2021. Methods: the research was conducted in four dengue-endemic villages in Ternate City, including Sangaji, Maliaro, Bastiong Karance, and Bastiong Talangame. In 80 households, egg density was determined utilizing ovitrap placement of up to two pieces per dwelling, one inside and one outside the house. After a week of ovitrap installation, the filter paper was collected, and the ovitrap index value was calculated. The value of the House Index (HI), Container Index (CI), and Breuteu Index (BI) was used to calculate the larval density. The type and materials of the containers were used to assess the parameters of the larval environment. Results: The ovitrap index value in the four sub-districts was categorized as moderate level 3 (27.50% -36.25%). The highest larval density was found in Sangaji Village (HI = 81%), while the lowest was in Bastion Talangame Village (HI = 70%). The highest CI and BI values were found in Bastiong Karance Village (CI=51.5% and BI=190%), and the lowest was in Maliaro Village (CI=37.5% and BI=128%). Density figures in all endemic villages have a high larval density with a value of 8. Conclusion: There was no significant difference (p>0.05) between the types and the materials of containers in each village in DF endemic areas. The high density of the egg and larval stage and the information characteristic of habitat Aedes spp. Could be considered the basis of information dengue vector prevention and control in Ternate City.

Addressing the Double Burden of Malnutrition using the Life Course Perspective

@#The double burden of malnutrition refers to the coexistence of undernutrition which is typically characterised by stunting and wasting, alongside overnutrition at all levels of the population. The objective of this article is to review the current issues in addressing the double burden of malnutrition using the life course approach. Studies addressing life course approach in DBM were identified through PubMed & EMBASE databases. Relevant studies were critically appraised. The challenges, opportunities and way forward in addressing DBM through the life course concept were discussed. The review showed that the DBM dilemma could be addressed via a holistic perspective through a life course concept as nutrition plays an important role in influencing health from pre-conception to old age. The life course concept proposes that environmental exposures, including biological, physical, social, and behavioral factors, including life experiences, throughout life, influence health outcomes in current generations and their offspring.

Are the coronavirus disease 2019(COVID-19)-themed applications launched during the pandemic sustainable? / 《全球健康杂志（英文）》

Many digital applications(Apps)were launched during the coronavirus disease 2019(COVID-19)pandemic for various purposes such as information sharing,risk assessment,self-management of symptoms,contact tracing,home monitoring,and decision making.Since the quality of CO VID-19-themed Apps varied and was less reliable based on measurements using the mobile Apps rating scale method,some of these Apps are considered useful while some are said to have the potential to harm users.This suggests the need for authorized institutions to validate and ensure the safety and security of these Apps before it was launched in public.This is necessary considering the potential dangers arising from App inaccuracies,as well as the potential misuse of user data due to data breaches.With these considerations in mind,we consider that the vaccine passport is an App with a COVID-19 theme that must be refined and applied sustainably amid the ongoing global crisis and the uncertainty of this pandemic.

Stability of lactoferrin and lysozyme in human milk at various temperatures and duration of storage

@#Introduction: Exclusive breastfeeding, especially in the first six months, is essential for infants as it provides nutrition and protection against various diseases. Colostrum, which is found in the first breast milk produced, contains various protective factors, such as lactoferrin and lysozyme. Human milk can be stored at room temperature, refrigerated, or kept frozen. Several factors affect the stability of the bioactive content in human milk, such as temperature and storage time. The aim of this study was to measure the stability of lactoferrin and lysozyme levels in human milk during the first six hours (h) at different temperatures and compare it with that of frozen human milk. Methods: Human milk samples were obtained from 11 breastfeeding mothers using certain criteria. The human milk was stored at room temperature and 4°C for 1, 3, and 6 h and classified as never frozen, while frozen human milk was stored at -20°C for 1, 3, and 6 days. Measurement of the lactoferrin and lysozyme levels was performed using enzyme-linked immunosorbent assay. Results: The results showed that storage at room temperature significantly reduced lactoferrin and lysozyme levels. Lactoferrin levels in frozen human milk did not significantly decrease during the first six days. Meanwhile, the lysozyme levels in frozen human milk decreased significantly. Conclusion: The levels of lactoferrin and lysozyme in frozen human milk stored for the first six days were more stable than those stored at room temperature and 4°C in the first 6 h.