Translation and validation of Indonesian version of Pediatric Quality of Life Inventory™ (PedsQL™) Neuromuscular Module.

BACKGROUND: The Pediatric Quality of Life™ 3.0 Neuromuscular Module is an instrument to assess health-related quality of life (HRQoL) among children with neuromuscular diseases (NMDs) aged 2-18 years. This study aimed to determine whether the PedsQL™ 3.0 Neuromuscular Module Indonesian Version is valid and reliable. METHODS: This study used the Indonesian translation of the PedsQL™ 3.0 Neuromuscular Module after getting formal permission from the inventor, and the translation process followed the Mapi linguistic translation guidelines. This study administered the PedsQL™ 3.0 Neuromuscular Module Indonesian Version to 84 parents and 71 children. In addition, we used the Rasch model to analyze the psychometric properties. RESULTS: The reliability of the total scale of the PedsQL™ Neuromuscular Module Indonesian Version shows good to very good criteria. On the parent proxy-report, Cronbach alpha was 0.95, person reliability was 0.84, item reliability was 0.93, person separation was 2.32, item separation was 3.61, person strata separation was 4 levels, and item strata separation was 5 levels. On the child self-report, Cronbach alpha was 0.93, person reliability was 0.81, item reliability was 0.81, person separation was 2.08, item separation was 2.06, person strata separation was 3 levels, and item strata separation was 3 levels. The total scale of the PedsQL Neuromuscular Module Indonesian Version shows fair to good construct validity in parent proxy-report (explained variance 51.9%; unexplained variance 8.4%) and child self-report (explained variance 40.9%; unexplained variance 12.6%). There were no misfit items in the parent proxy-report (infit 0.66-1.49; outfit 0.51-1.81; point measure correlation 0.36-0.93) and child self-report (infit 0.53-1.65; outfit 0.50-1.73; point measure correlation 0.31-0.90) identified by the Rasch models. CONCLUSIONS: The PedsQL™ 3.0 Neuromuscular Modul Indonesian Version is a valid and reliable instrument in measuring HRQoL in Indonesian children with neuromuscular diseases.

Effect of Eel Biscuit Supplementation on Height of Children with Stunting Aged 36-60 Months: A Pilot Study.

BACKGROUND: Stunting is a major health problem in developing countries. Animal-based supplements can increase the height of children with stunting. This study was aimed at determining the effect of eel biscuit supplementation on increase in the height of children with stunting aged 36-60 months. METHODS: A pilot study with pretest-post-test design. The study was conducted in two villages in the Priangan Region, West Java Province, Indonesia. The participants were divided into two groups: intervention group (10 supplemented eel biscuit pieces) and control group (biscuits from the government's biscuit programme). A total of 56 children aged 36-60 months with the height-for-age z-score of <-2 SD were recruited voluntarily for sampling. RESULTS: The initial height-for-age z-score of the intervention group was -3.45 SD and that of the control group was -3.11 SD. After 3 months of supplemented eel biscuit consumption, the height-for-age z-score of the intervention group changed to -2.52 SD and that of the control group changed to -2.51 SD. The average shift of the height-for-age z-score after 3 months of supplemented eel biscuit consumption was 0.93 SD in the intervention group and 0.6 SD in the control group. There were significant differences in delta and percent increase in the height-for-age z-score between both groups. CONCLUSIONS: Consumption of supplemented eel biscuits for 3 months increased the height-for-age z-score of children with stunting aged 36-60 months by 0.93 SD.

Does your neighborhood protect you from being depressed? A study on social trust and depression in Indonesia.

BACKGROUND: Prevalence of depression in Indonesia is estimated at about 3.7% of the total population, although the actual may be higher. Studies worldwide have linked the environment where people live to their mental health status. However, little research is found in Indonesia regarding this link. We examined the association between individuals' perception towards their neighborhood and their depression symptoms. METHODS: Social trust was measured at the individual (level 1) and community (level 2) levels based on the Indonesian Family Life Survey 5 (IFLS5) in 2014. Depression was measured using the 10-item Center for Epidemiologic Studies-Depression Scale Revised (CESD-R-10) and the scores were transformed into logit form using the Rasch model. Multilevel regression was used to determine correlations. RESULTS: Of the total sample of 14,227 respondents in this study, about 19.4% had experienced severe depression symptoms in the past week. Social trust was found to be significantly associated with severe depression symptoms. The weaker the individuals' social trust towards their neighbourhood, the higher the probability of experiencing severe depression symptoms would be. CONCLUSIONS: This study shows that social trust is associated with the severity of depression symptoms: the higher the social trust, the lower the probability of having severe depression symptoms is. Depression symptoms may also be attributed to significant differences between communities.

Factors Influencing Disability Inclusion in General Eye Health Services in Bandung, Indonesia: A Qualitative Study.

The Inclusive System for Effective Eye-care (I-SEE) is a pilot project for disability inclusion in eye health in Bandung district of Indonesia. The aim of this research was to investigate factors influencing the introduction, i.e., adoption, implementation and continuation of I-SEE. A qualitative exploratory study was conducted by interviewing relevant stakeholders (n = 27) and users with disabilities (n = 12). A theoretical framework on the introduction of innovations in health care was used to guide data collection and thematic analysis. Factors related to the characteristics of the innovation (I-SEE) (e.g., infrastructure, equipment, engagement of people with disabilities, inclusive communication), service provider characteristics (e.g., motivation, attitudes, training), organizational characteristics (e.g., supervision, indicators, data), and the socio-political context of I-SEE (policy, motivation of users, family support, costs, transport) were essential for supporting the introduction process. Additionally, stakeholders proposed strategies for enhancing the introduction of I-SEE (e.g., awareness, collaborations). While there are specific disability related factors, most factors influencing the introduction of disability inclusive eye health were similar to introducing any innovation in general health care. Strategies for disability inclusion should be included from the planning phase of an eye health program and are reasonably simple to adapt.

Water Sources Quality in Urban Slum Settlement along the Contaminated River Basin in Indonesia: Application of Quantitative Microbial Risk Assessment.

Fecal contamination in water sources is still found globally, especially in urban slum areas of mid-low income countries. Fecal contamination as an indicator of low levels of hygiene and sanitation practices as well as poor management of drinking water supply might increase the risk of waterborne diseases in developing countries like Indonesia. This study aimed to assess quality of all water sources in one of the urban slum settlements along a contaminated river basin in Indonesia. A cross-sectional survey was conducted during the period of August to October 2015. Water samples were taken with simple random sampling from households in urban slum areas along the Cikapundung river basin in the center of Bandung city, Indonesia. Water samples (n=379) from 199 households and 15 common wells were tested for microbiological contamination, and 61 samples of ground water sources and river were tested for selected heavy metal contamination. Annual risk of infection from all water sources was calculated using the quantitative microbial risk assessment. Tap water distribution was poor in this slum area. Most of the dug wells and half of refill bottled water were contaminated. Estimated highest annual risks of infection due to fecal contamination would be caused by dug well and spring water since majority of the households did not use septic tank and disposed human waste directly to the river. Improvement in point-of-use water treatment and storage is essential to prevent risk of waterborne diseases, and tap water should be more accessible and affordable in urban slum areas. The integrated monitoring system to control the quality of refill bottled water production is one of the many essential issues to be prioritized.

Development of forensic medicine in post reform Indonesia.

Forensic medicine practice in Indonesia was introduced through the Dutch colonial criminal justice system in the early twentieth century. After more than 70 years of national independence, the development of forensic medicine still faces fundamental challenges, including confusion in the distribution of responsibility with law enforcement agencies, difficulties in managing conflicts of interest, and impediments in scientific practice and professional development. Despite of the golden opportunity from the Indonesian Reform movement in the late 1990s, the impact on forensic medicine development has been less than expected. It is thus important to identify the scope of the problems plaguing the development of forensic medicine, as well as its causes. We conducted a qualitative study to explain the problems and propose solutions. The results show that the standards of practice have developed more slowly than those in many other branches of medicine, despite its increasing popularity from its role in counterterrorism and disaster victim identification. A strong thriving spirit exists in forensic science, although growth in forensic research activities should be facilitated more. The 2009 Health Law has included forensic medicine practice in the health system to cover the role of forensic medicine for health and medical education purposes. It also potentially provides a way to support the justice system without exposing forensic practitioners to possible conflicts of interest, for instance, by utilizing a tiered referral system. To this aim, an alternative is proposed: to place forensic medicine practice within the context of the health system.

Effects of Selenium Supplementation on the Diabetic Condition Depend on the Baseline Selenium Status in KKAy Mice.

Oxidative stress in obesity leads to insulin resistance in type 2 diabetes. Some selenoproteins possess antioxidant properties, suggesting that selenium (Se) may protect against type 2 diabetes; however, evidence from epidemiological studies is contradictory. We hypothesized that Se status before supplementation (baseline) contributes to the supplementation outcome. This study aimed to clarify the influence of baseline Se status on the effect of Se supplementation on the diabetic condition. Six-week-old KKAy mice were fed a diet without supplemental Se or with 0.1 ppm Se in the form of L-selenomethionine (SeM) for 2 weeks to create low-Se and sufficient-Se baseline statuses, respectively. For the next 4 weeks, low-Se mice were given a SeM (0.5 ppm Se)-supplemented diet, and sufficient-Se mice were given either a SeM (0.5 ppm Se)- or sodium selenite (0.5 ppm Se)-supplemented diet; control groups continued on baseline diets. Serum Se concentrations, glutathione peroxidase (GPx) activities, adiponectin levels, glucose tolerance, and insulin sensitivity were analyzed. All mice became diabetic during the 2-week baseline induction period. At the end of the supplementation period, Se-receiving groups demonstrated significantly higher Se concentrations and GPx activities than their respective controls. Sufficient-Se mice receiving SeM had lower blood glucose levels and better insulin sensitivity than control and sodium selenite-receiving mice, whereas low-Se mice receiving SeM showed no such improvements compared with their controls. Our results suggest that Se supplementation in the form of SeM may help prevent type 2 diabetes aggravation in people taking the 55 µg/day Se recommended dietary allowance.