Resilience in Relation to Adherence to Antiretroviral Therapy in People Living With HIV: A Qualitative Study.

Antiretroviral therapy (ART) adherence significantly impacts the survival and quality of life of people living with HIV (PLWH). Despite the challenges faced by PLWH, adherence remains crucial. Thus, cultivating resilience in ART is essential for optimal treatment outcomes. This qualitative study explored the experience of resilience in relation to ART adherence among PLWH. Semi-structured interviews with 10 participants were conducted and inductively analyzed. Participants' resilience in ART adherence was reflected in their achievements related to cultivating the habit of taking medication and in their convictions that the medication was a daily necessity. PLWH developed resilience through strategies encompassing finding purpose through faith and motivation, fostering wellness by obtaining adequate information, enjoying life, managing disease therapy, and adopting a healthy lifestyle, and building connections by finding adequate support and involving in the community. Nurses are crucial in HIV management, fostering resilience for successful ART adherence and ensuring effective treatment outcomes.

Role of CD44 and CD24 Expression on 2-years Disease Free Survival in Patients with Advanced Epithelial Ovarian Carcinoma.

OBJECTIVE: Ovarian cancer is one of the most common cancers with a high mortality rate worldwide. Despite optimal surgical therapy and chemotherapy, recurrence is still common. Cancer stem cells expressing CD44 and CD24 are thought to be contributing factors in recurrence. METHODS: A cohort retrospective study with survival analysis was carried out on advanced ovarian cancer patients who underwent optimal debulking surgery followed by 6 cycles of chemotherapy at Cipto Mangunkusumo General Hospital and Fatmawati General Hospital from January 2019 to March 2023. Immunohistochemical examination was performed on tumor tissue with CD44 and CD24 expression were assessed using the H-Score method then determined the cut off-point expression level using the ROC curve. Furthermore, the relationship between these expression levels with the disease-free survival was assessed using the survival curve. RESULTS: There were 48 subjects who were included in the study. There were high expression levels of CD44 in 47.9% and CD24 in 50% of cases. High CD44 expression had mean and median survival of 13.2 ± 1.8 and 11 months (HR 5.05, 95% CI 1.84- 13.85). High CD24 expression had mean and median survival of 13.5 ± 2.4 and 7 months (HR 7.73, 95% CI 2.58 - 23.15). The combination of the two high expressions had mean and median survival of 10.44 ± 1.88 and 7 months. CONCLUSION: High expression of CD44 and CD24 will shorten the disease-free survival of patients with advanced ovarian cancer.

Validity and reliability test of the brief symptom rating scale 5 (BSRS-5) questionnaire in Indonesian version as an assessment tool for psychological disorders in Indonesia.

BACKGROUND: Psychological disorders in workers is associated with physical health problems and decreased work productivity costing the impact of workplace accidents. We can minimize these problems by introducing screening programs with a simple screening tool for psychological disorders. One of the questionnaires used in several countries to assess psychological disorders is the Brief Symptom Rating Scale - 5 (BSRS-5). Thus, this study aimed to assess the validity and reliability of the Brief Symptom Rating Scale - 5 (BSRS-5) in the Indonesian version. METHODS: The BSRS-5 was translated into a local language (Bahasa), and experts judgment in the forward and backward translation process. What collected BSRS-5 data in a primary health care setting on 64 respondents. Internal reliability was tested using Cronbach's alpha. Factorial validity was done using exploratory factor analysis to investigate whether BSRS-5 items properly measure the underlying dimensions of psychological disorders. External (criterion) validity was analysed by looking at the relationship between BSRS-5 and Depression, Anxiety and Stress Scale - 21 (DASS-21), using the coefficient correlation. RESULTS: The BSRS-5 questionnaire was produced from transcultural validation using the ISPOR method. The results of the construct validity test for all questions between (0.634-0.781) with a significance level < 0.05. The factor analysis values for all statements > 0.3 were all items having Eigenvalues > 1 yielded into one factor. The instrument performed well in detecting common psychological disorders. The BSRS-5 had good internal reliability (α = 0.770). The external validity test results with DASS-21 showed that BSRS-5 correlated with the DASS-21 dimensions of depression and stress with correlation values of 0.397 and 0.399. In opposition to correlated BSRS-5 with the dimension of anxiety in DASS-21 showed no correlation with a correlation value of 0.237. Therefore, another gold standard questionnaire is required to evaluate psychological distress based on each item in BSRS-5. CONCLUSION: The BSRS-5 is a satisfactory screening tool for identifying common psychological disorders such as Insomnia, Anxiety, Depression, Hostility, and Inferiority in the community. The absence of correlation with anxiety in this assessment tool needs another gold standard questionnaire, or professional assistance is required for further evaluation to follow up on psychological disorders.

Acetic Acid and Iodine Staining for Determining Malignancy in Solid Tumors.

OBJECTIVE: Surgical margin is an important prognostic factor in solid cancer surgery. Frozen section (FS), the gold standard for intraoperative surgical margin evaluation, requires extensive waiting time and expensive FS devices. The purpose of this diagnostic study was to verify whether multi-staining (MS) method with acetic acid and iodine could be used to differentiate malignant and non-malignant lesions of solid tumor. METHODS: The study was conducted on patients with solid tumor who underwent surgery in the Surgical Oncology Division of Dr. Cipto Mangunkusumo General Hospital from December 2017 to April 2018. Samples measuring less than 5 mm, necrotic tissue sample, and patients who did not agree to participate in the study were excluded. Every specimen was divided into two, one side as unstained control and the other side as MS samples. MS samples were sprayed with 10% acetic acid combined with iodine. MS samples and unstained controls were sent for histopathologic results and the pathologist was blinded to group assignment. Acetowhitening reaction in the sample was an indication of a positive MS result, and the presence of malignant foci in the histopathology examination was classified as positive pathological results. RESULTS: Five-hundred-and-twenty samples were obtained from 150 patients. MS method was found to have sensitivity and specificity of 82%, and 63.5%, respectively. In subgroup analysis, we found that MS method has a sensitivity and specificity of 100% and 79.3%, respectively for epithelial breast tumor; 65.7% and 83.3%, respectively for thyroid nodules; and 94.1% and 33.3%, respectively for oral cavity tumors. MS method reacts positively to solid malignant tumor and negatively to benign tumor and normal tissue (from margin samples). Highest sensitivity was found for breast and oral cavity malignancy, and high specificity was found for thyroid cancers. CONCLUSION: This study provided an alternative staining method for intraoperative macroscopic surgical margin evaluation, especially for rural areas without frozen section facilities.