Combination of Curcuminoids and Acupressure for Inflammation and Pain in Older People with Osteoarthritis Genu: Protocol for a Randomized Controlled Trial.

BACKGROUND: Curcuminoids and acupressure have beneficial effects in reducing pain and inflammation in patients with osteoarthritis. However, only a few clinical trials are investigating biomarkers to prove this objectively. OBJECTIVE: This study aims to investigate the effect of acupressure and curcuminoids on inflammatory markers and pain in older people with osteoarthritis genu. METHODS: A randomized controlled trial (RCT) was conducted among older people with osteoarthritis. All participants were randomized to a group that received 30 mg of curcuminoids in turmeric extract capsules and acupressure (group 1) or a group that received a placebo and sham acupressure (group 2) for 3 weeks. RESULTS: The study was approved by the research ethics board; ClinicalTrials.gov reviewed this protocol. The extracts were manufactured from May 2023 to June 2023. Participant recruitment was conducted in September and October 2023; a total of 72 participants aged 60 years or older participated, of whom 75% (n=54) were female. Data were analyzed in April 2024, and dissemination of results is expected by the end of 2024. CONCLUSIONS: Primary outcomes were assessed at baseline and after the intervention. Relationships were assessed with inflammatory markers, endorphin hormones, and blood level of cycloxygenase-2 hormone. Additionally, secondary outcomes included pain, ability to perform activities of daily living, and quality of life. The beneficial effects that may be found in this trial may be exceptionally relevant in clinical practice, justifying this scientific inquiry. The benefits of herbs and acupressure can be helpful as additional options in treating inflammation and pain in patients with osteoarthritis. TRIAL REGISTRATION: ClinicalTrials.gov NCT06105840; https://clinicaltrials.gov/study/NCT06105840. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/54970.

Effect of care for child development training on cadres' knowledge, attitude, and efficacy in Yogyakarta, Indonesia.

Background: Stunting is a common malnutrition problem among children in the world. The Care for Children Development (CCD) intervention is a strategy to reduce stunting. Objective: This study aimed to identify the effect of culturally modified CCD training on the knowledge, attitude, and efficacy (KAE) of cadres about stunting in the community. Methods: We conducted a community-based study with a quasi-experimental research design using a comparison group. The study was conducted from March 2018 to February 2019 at three Public Health Centers in Yogyakarta, Indonesia. The total participants were 69 in the intervention group and 53 in the comparison group. Cadres in the intervention group received two days of training on a culturally modified CCD guideline. In contrast, cadres in the comparison group received a brief explanation (a one-day training) on that program. The nurses from three public health centers were facilitators in this training. Knowledge and self-efficacy were assessed using a modified Caregiver Knowledge of Child Development Inventory and General Self-efficacy Scale, respectively. Data were analyzed using Mann-Whitney U and Wilcoxon tests. Results: All 122 cadres completed the training. In the intervention group, CCD training significantly increased cadres' knowledge (median score 14 vs. 11), attitude (58 vs. 55), and efficacy (30 vs. 28), all with p <0.001. In the comparison group, the short explanation of CCD significantly improved cadres' knowledge (median score 12 vs. 10) and efficacy (29 vs. 27) but not their attitude. The delta or change in score before and after CCD training for cadres' attitude in the intervention group was significantly higher than that of the comparison group (3.78 vs. 0.72; p = 0.050). Conclusion: A culturally modified CCD training significantly improves cadres' KAE in the intervention group and cadres' knowledge in the comparison group. The learning delivery methods with demonstrations and role-plays significantly improved the cadres' attitudes as health educators for stunted mothers in the community. For sustainability, community health nurses should regularly collaborate with cadres to improve the nutritional status of children in their area.

Biometric indicators can be early signs of declines in activities of daily living functioning among the Indonesian elderly.

BACKGROUND: Signs associated with the onset of disability can be useful in disability projection and have significant implications in elderly care policy. OBJECTIVE: To explored the associations between biometric screening indicators and declines in activities of daily life (ADLs) functioning among the Indonesian elderly. METHODS: This is a prospective longitudinal cohort study. The Indonesian Family Life Survey (IFLS) 4 conducted in 2007-2008, and IFLS 5 conducted in 2014-2015 were used to assess the association between biometric indicators and ADLs at baseline and follow-up. RESULTS: Findings revealed that 22.3% of participants surveyed in 2007-2014 had become disabled in terms of ADLs. Anemia status, stage 2 hypertension, lung capacity, and a longer sit-to-stand time were associated with ADLs. CONCLUSION: These findings are important to help early detection and potentially help the prevention of ADLs in elderly people in the future. Accuracy of disability estimation could possibly be improved if including biometric parameters.

Preparing Short Message Service Reminders to Improve Treatment Adherence among Tuberculosis Patients in Sleman District, Indonesia.

BACKGROUND: Modern tuberculosis (TB) treatment approaches require innovative adherence strategies. OBJECTIVES: This study aimed to explore the feasibility of using short message service (SMS) reminders through mobile phones to improve treatment adherence among TB patients. MATERIALS AND METHODS: An exploratory sequential design was applied; initially, qualitative data collection was conducted among TB patients and TB program officers. A content analysis was done and messages were then developed. The messages were pretested using focus group discussions (FGDs), and a quantitative method using quasi-experiment on 120 TB patients. All the patients received a standard directly observed therapy short reminder, but only intervention group received daily SMS reminders (n = 60), the data were then analyzed using logistic regression. RESULTS: Reminder messages can be sent directly to young TB patients or indirectly to the relatives of elderly patients. There are four phases of emotional states, which TB patients go through during treatment starting with disappointment and desperation after being diagnosed, grievance during the initiation of treatment, high and then low desire to follow treatment. Reminder messages aimed at improving treatment adherence should correspond to those conditions and motivate, inform, and facilitate TB patients to overcome all the obstacles during treatment. SMS reminders should also be short, informal, and easy to understand. Treatment adherence was significantly higher among the intervention group compared to the control group (odds ratio = 10.73) after controlling for demographics, accessibility, and adverse drug reaction. CONCLUSIONS: SMS through mobile phone is a feasible form of media to remind TB patients and to improve adherence to treatment in low-resource facilities.

Factors associated with the use of outpatient services among the elderly in Indonesia.

BACKGROUND: Elderly people tend to have greater healthcare utilization because of their health status. However, with the 4th largest population in the world, little is known concerning the use of services among the Indonesian elderly. Hence, this study aimed to identify factors related to the use of outpatient services among the Indonesian elderly. METHODS: This is cross sectional study using data from the Indonesian Family Life Survey 5 (IFLS 5), conducted in 2014 and 2015. Only those who were 60 years or older were included in the analyses. We used a logistic regression analysis to determine factors associated with use of outpatient services. RESULTS: Among 2912 participants, only 22.7% of respondents had visited health workers or doctors within the previous 4 weeks before the survey. After controlling for other variables, factors associated with the use of outpatient services were socioeconomic status, insurance status, regions of residence, self-rated health, and the number of chronic conditions. CONCLUSION: Inequality in outpatient services was observed among the elderly in Indonesia. More effort is need to expand insurance coverage for the elderly, particularly for those in the lower economic status, and to improve access to outpatient services in rural regions by allocating the needed resources.