Abstract
Background
Tugboat crewmembers are susceptible to fatigue during their 24-h work shifts, despite the availability of rest time. The fatigue experienced by seafarers contributes to marine ...accidents and metabolic and cardiovascular diseases, which have long-term effects. This study aimed to analyse the association between working hours and fatigue and other possibly related factors in tugboat crewmembers.
Method
This comparative cross-sectional study included 127 tugboat crew members from 15 randomly chosen tugboats in Samarinda Harbor, Indonesia. Their fatigue levels while at work were measured using a reaction timer and standardised questionnaire. Personal and occupational data of crewmembers, including age, marital status, rating (job ranking), duration on board, length of seafaring experience, watch system, smoking status, coffee and alcohol consumption, and working hours, were collected. Moreover, sleep quality and stress levels related to work-family conflict were measured and analysed using the Pittsburgh Sleep Quality Index (PSQI) and Work-Family Conflict Scale (WCFS), respectively.
Results
The study found that 40.2% of the subjects were classified as having fatigue. The determinant factors were long working hours (> 72 h/week), poor sleep quality, and work-family conflict adj. OR = 13.32; 95%-CI (4.78–31.23) and
p
< 0.001, adj. OR = 4.49 (1.39–14.52) and
p
= 0.012, adj. OR = 2.87 (1.12–7.33) and
p
= 0.028, respectively. However, personal and occupational factors, including age, marital status, duration on board, length of seafaring experience, smoking status, and coffee and alcohol consumption, were not significantly associated with crewmember fatigue.
Conclusion
The incidence of fatigue among Indonesian tugboat crewmembers operating on the Mahakam River was considerably high. Working hours, sleep quality, and work-family conflict were strongly associated with fatigue in tugboat crewmembers; therefore, the working hours of tugboat crewmembers need to be improved. Crewmember lifestyle variables need to be studied further.
Initiating discussion about death and dying is often considered a difficult topic for healthcare providers, thus there is a need for further research to understand this area, particularly in ...developing countries. The aim of this study was to describe preferences for the initiation of end-of-life care discussions in Indonesia, comparing the general population and health care professionals.
This cross-sectional, descriptive study analysed quantitative data from 368 respondents to an online questionnaire (255 general population (69%); 113 healthcare professionals (31%)) utilizing consecutive sampling and snowball sampling methods.
Overall, most respondents (80%) stated that they would like to discuss end-of-life issues with a healthcare professional in the case of terminal illness. This was more marked amongst healthcare professionals compared with the general population (94% vs. 75%, respectively, p < 0,001). The preferred time for discussion was at first diagnosis (68% general population, 52% healthcare professionals, p = 0.017) and the preferred person to start the discussion was the doctor (59% general population, 71% healthcare professionals, p = 0.036). Fewer respondents wanted to know about prognosis compared to diagnosis (overall 76% v 93% respectively).
Doctors have vital role in end-of-life care discussion, and attempts should be made to encourage physicians to initiate these conversations and respond to patient's requests when needed. These findings contribute to the existing body of knowledge in this area of practice, with focus on a developing country. The role of socio-cultural influences on these conversations warrants further research, in order to develop practical resources to support clinicians to appropriately conduct end-of-life care discussions with their patients and to provide data for policymakers to develop services.
This mini review explores the transformative potential of big data analysis and artificial intelligence (AI) in reforming occupational medicine in Indonesia. Emphasizing the preconditions, case ...studies, and benefits, it underscores the role of big data in enhancing worker well-being. The review highlights the importance of informative health big data, especially in high-risk industries, with examples of case studies of AI implementation in occupational medicine during the COVID-19 pandemic and other relevant scenarios. While acknowledging the challenges of AI implementation, the essay identifies the role of academic and professional organizations as pioneers in big data utilization. Six potential benefits that are identified, including improved patient care and efficient resource allocation, demonstrate the transformative impact of big data analysis. The proposed pathway of preparation underscores the need for awareness, skill enhancement, and collaboration, addressing challenges in data management and stakeholder engagement. The conclusion emphasizes continuous assessment, feasibility studies, and commitment as essential steps in advancing occupational medicine through big data analysis.
Revascularization is important for the healing of diabetic foot ulcers with peripheral arterial disease because it aids in the restoration of the perfusion function of the leg tissues and can reduce ...the risk of cardiovascular complications. However, no Indonesian studies have been identified that exclusively discuss the effectiveness of revascularization for patients with this condition. This study aimed to compare the healing rates of diabetic foot ulcers with peripheral arterial disease in patients who received or did not receive revascularization.
This cohort study included diabetic foot ulcer patients with peripheral arterial disease undergoing treatment at our institution who received or did not receive revascularization based on the wound, ischemia, and foot infection (WIfI) score criteria. Wound healing was considered complete re-epithelialization within six months of the procedure or consistent epithelialization for four consecutive weeks. Patients who required amputation within six months of observation were deemed to have failed therapy.
Each group contained 23 patients. The revascularization group exhibited a healing rate of 78.3 % (18 patients), while the non-revascularization patients had a rate of 26.1 % (6 patients). The wounds of revascularized patients were 14.944 (1.102–202.692) times more likely to heal than those without revascularization (p < 0.01). WIfI stage 2–3 patients showed an 11.926 (1.438–98.883) times increase in the likelihood of wound healing compared to stage 4 WIfI patients.
The wound healing rate was higher for revascularized patients than for non-revascularized patients, and the severity of the wound based on WIfI score affected patient wound healing.
Abstract
Background
Agriculture is a major economic sector in Indonesia. Chemical pesticides are widely being used in agriculture for controlling pest. There is a growing concern that pesticide ...exposure, particularly chlorpyrifos (CPF) exposure, combined with other occupational characteristics that determine the level of exposure, can lead to further health impacts for farmers. Our objective was to evaluate the cumulative exposure characteristics among farmers exposed to CPF by using a validated algorithm.
Methods
We conducted a cross-sectional study of 152 vegetable farmers aged 18–65 who actively used CPF for at least 1 year in Central Java, Indonesia. Subject characteristics were obtained using a structured interviewer-administered questionnaire, addressed for sociodemographic and work-related characteristics. The cumulative exposure level (CEL) was estimated as a function of the intensity level of pesticide exposure (IL), lifetime years of pesticide use and the number of days spraying per year. CEL was subsequently classified into two groups, high and low exposure groups. The difference in characteristics of the study population was measured using Chi-square, independent-t or Mann-Whitney test. Association between CEL and its characteristics variables were performed by multiple linear regression.
Results
Seventy-one subjects (46.7%) were classified as the high exposure group. The use of multiple pesticide mixtures was common among our study population, with 94% of them using 2 or more pesticides. 73% reported direct contact with concentrated pesticides product, and over 80% reported being splashed or spilt during preparation or spraying activity. However, we found that the proportion of proper personal protective equipment (PPE) use in our subjects was low. Higher volume of mixture applied (
p
< 0.001) and broader acres of land (
p
= 0.001) were associated with higher cumulative exposure level, while using long-sleeved clothes and long pants (
p
< 0.05) during pesticide spraying were associated with lower cumulative exposure after adjusted for age and gender.
Conclusions
These findings indicate an inadequate knowledge of using pesticides properly. Thus, we recommend comprehensive training on pesticide usage and encourage proper PPE to reduce the exposure level.
The mIRNA519a-3p and NKG2D in endometriosis Pramayadi, Cepi Teguh; Natadisastra, Muharam; Sumapradja, Kanadi ...
Indonesian Journal of Obstetrics and Gynecology,
10/2022
Journal Article
Peer reviewed
Open access
Background: Natural killer (NK) cells play a role in pathogenesis of endometriosis. Lower expressions of NK cells receptor group 2D (NKG2D) ligands inhibits cytotoxic activity of NK cells; a common ...immunity avoidance mechanism in neoplasms. Literatures have proven miRNAs regulatory effect on NKG2D expression. There has been no specific biomarker for diagnosing endometriosis. Non-invasive means of diagnosing endometriosis may reduce well-known risks of invasive method of diagnosis and yield better results.
Purpose: To investigate the correlation between miRNA-519a-3p expression with NKG2D ligands (MICA, MICB, ULBP 1-6) on endometriosis and non-endometriosis patients.
Methods: This was a cross-sectional study held in five centers: dr. Cipto Mangunkusumo General Hospital, Pelni Hospital, Bunda Hospital, YPK Mandiri Hospital, and Primaya Evasari Hospital from October 2020 to July 2021. miRNA and NKG2DL analysis were done in Human Reproduction, Infertility and Family Planning (HRIFP) cluster at IMERI FKUI.
Results: We obtained 19 patients in each study groups. NKG2D ligands and miRNA519a-3p relative expressions were not significantly different (p > 0.05). Increased miRNA519a-3p expression negatively affected NKG2D ligands expression. A decrease in ULBP1 and an increase in ULBP2 increased the probability for endometriosis. NKG2D ligands expression may be influenced by infection, pro-inflammatory cytokine production, dan polymorphism. NKG2D ligands expression level can be different depending on the origin of the sample. Lower expression of miRNA519a-3p indirectly inhibits tumor apoptosis by lowering NKG2D ligands, caspase, or mRNA.
Conclussion: We did not manage to establish a correlation between NKG2D ligands with miRNA519a-3p in endometriosis and non-endometriosis patients.
Introduction: Multifocal electroretinography (ERG) is an examination which measures retinal electrical activity as a response to lighting stimulus and allows simultaneous recording in many ...topographic locations. Various electrodes have been developed to balance examination accuracy and also patients’ comfort. The objective of this study is to establish normal values of multifocal ERG and to compare the values and the comfort level using Jet, Dencott and DTL electrode in Indonesian Adult.
Methods: Through convenient sampling 49 normal Indonesian subjects between 19 and 49 years old were selected. Multifocal ERG amplitudes and implicit time values were measured according to recommendation by the ISCEV. Evaluation consisted of N1 and P1 wave in ring 1 to 5. after the examination, all subjects filled in a questionnaire about comfort level, adopted from the visual analog scale.
Result: We observed a statistically significant difference in multifocal ERG normal values between electrode with higher wave amplitudes and longer implicit time in Jet and Dencott electrodes compared to DTL electrodes. Jet and DTL electrodes are more comfortable than Dencott electrodes for Indonesian adults in multifocal ERG.
Conclusion: DTL electrodes give the lowest wave amplitude and the shortest implicit time and are the most comfortable electrode compared to Jet and Dencott electrodes, in multifocal ERG in Indonesian adults.
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