Ageing in Indonesia - Health Status and Challenges for the Future

Ageing and problems concerning the aged were until recently the domain of developed countries, but they are now becoming an increasing and alarming reality in developing and underdeveloped countries such as Indonesia. Families and even the nation are facing many challenges relating to support for the elderly. This is because in the past developing policies, and caring for, the elderly were not major priorities of Government as the elderly represented a small percentage of Indonesia???s population. One of the challenges impacting on the provision of care for the elderly is the lack of health service programs for the elderly who are living in their own homes. Health personnel shortages including community health nurses have been identified as a significant contributor to this health service problem. This paper will initially consider Indonesia???s geography as a nation comprising many islands. It will then discuss the impact of a changing population profile and present an overview and critique of the current level of health services provided to promote wellbeing for the elderly

Hayek Deserves a New Paradigm, Not Old Ideological Categories: Response to Searles

Like Harrison Searles, we’re confident that modern evolutionary science provides a useful toolkit for economics and public policy. Some progress has been made advancing a new paradigm. Searles rightfully calls attention to the pioneering work of Friedrich Hayek. We are in a much better position to approach these topics now than during Hayek’s time. We think that modern multilevel selection theory and complexity theory lead to conclusions different than those that Searles and others draw from Hayek’s work. But we suggest dropping terms such as “evolutionary left” as a first step toward acknowledging that new paradigms cannot be shoehorned into old ideological categories. In our view, the new evolutionary paradigms promise to transcend the old ideological categories

Intervensi Health Coaching dalam Meningkatkan Self-Care Management Pasien Heart Failure

This study aims to identify the literature that explores health coaching interventions in improving Heart Failure (HF) self-care management, focusing on the total duration and type of health coaching media. The research method uses literature reviews by tracing publications between 2017-2020, the Cochrane database, PubMed, ScienceDirect, ProQuest, and Garuda. The results identified five health coaching studies according to inclusion criteria and resulted in significant improvements in HF self-care management, including symptom reporting, increased physical activity, low-salt diet, fluid and drug intake, self-efficacy, adherence to measuring body weight and blood pressure, and changes. Lifestyle, even though there are differences in the health training methods used. In conclusion, the duration and different media from each study did not significantly influence improving HF self-care management.   Keywords: Heart Failure, Self-Care Management, Health Developmen

Psychotropic Drug and Oxidative Stress in Acute Poisoning

Psychotropic drug poisoning is an important cause of mortality and morbidity in many countries. It has been estimated that there are 3 million cases of severe poisoning occur in developing countries. Amitriptyline is the most common suicidal poison with high morbidity and mortality and account for a large proportion of patients admitted to intensive care units. It is noted that acute amitriptyline poisoning accounted for 15-20% out of total admission to the medical intensive care units of Government Hospitals. Though routine standard treatment (RST) is being given to all acute amitriplyline poisoning (AP) cases, the exact mechanism of toxicity still remain elusive. Studies on acute amitriptylene poisoning patients indicate that besides their inhibiting effect on acetylcholinesterase, acute amitriptyline poisoning may induce oxidative stress in humans. The main objective of this study was to find out the antioxidant status, enzyme variations in acute amitriptyline poisoning cases. Vitamin C or ascorbic acid is a monosaccharide antioxidant found in both animals and plants. As it cannot be synthesized in humans and must be obtained from the diet, it is a vitamin.9 It is a water -soluble antioxidant that protects organic and biological molecules against oxidative degradation. It also works along with glutathione peroxidase (a major free radical - fighting enzyme) to revitalize alpha lipoic acid a fat-soluble antioxidant. Due to its versatile properties it is decided to supplement to acute amitriptyline poisoning cases. Alpha lipoic acid initially classified as a vitamin possessed potent antioxidant properties. It dissolves in both water and fat and thus claimed to be an "Universal antioxidant" it can reach tissues composed of fat such as the nervous systems as well as those made mainly of water such as heart. Alpha lipoic acid is seen to be very effective in various neurological disorders like Parkinson's diseases, Alzhmeir's diseases. Since acute amitriptyline poisoning causes considerable neurotoxicity, we have dicided to supplement alpha lipoic acid to acute amitriptyline poisoning cases and study its effect before and after supplementation. During the course of this study, observed elevated LDH and CPK activity in all acute amitriptyline poisoning cases, we were interested in knowing the exact fraction of isoenzyme elevation so as to find out the maximum tissue or organ damage in acute amitriptyline poisoning cases. A total of 132 acute amitriptyline cases were selected for study from IMCU and poison centre, Government General Hospital between September 2004 to March 2008, informed consent was obtained from the attendants of the patients. This study was approved by the ethical committee of Madras Medical College, Chennai - 3. The severity of poisoning was graded according to the method of Edinburgh Scale. Venous blood was drawn from each experimental subjects, antioxidant levels, enzymes and isoenzyme patterns of CPK and LDH were carried out for patients. 50ml of gastric aspirate was collected from all patients and this is taken for identification of amitriptyline drugs by TLC. Blood investigations were carried out by standard procedures by semi autoanalyzer, spectrophotometer, chromatographic techniques and semiautomated electrophoresis system. Statistical evaluation was carried out using SPSS (Version 14.0). Data obtained from the study groups were compared with variable by student `t' test, standard deviation, mean, ANOVA and percentage of benefit with and without supplementation of Vitamin C, alpha lipoic acid and in combination. Multiple comparison of each group with normal and without antixoidants was carried out using Bonferroni t-test. Standard tables and charts are depicted whenever required. Results were discussed in detail for all parameters with the literature available and observations were recorded. Based on the study the conclusions are arrived as follows. 1. Supplementation of Vitamin C, alpha lipoic acid and their combination decrease the oxidative stress and increase total antioxidant status of acute amitriptyline poisoning cases. 2. The effect of supplementation of Vitamin C and alpha lipoic acid combination was maximum in Group V acute amitriptyline poisoning cases. The longer supplementation of antioxidant combination will help the recovery of acute amitriptyline poisoning cases and also to reduce their long term side effects such as amitriptyline induced delayed neuropathy (AIDN). I.V. form of supplementation will be more beneficial for acute amitriptyline poisoning cases, also supplementation of these antioxidants to chronic amitriptyline poisoning cases will reduce their long term side effects. 3. The recovery and regeneration of plasma cholinesterase was more rapid than RBC cholinesterase. 4. Significant decrease in catalase activity was noticed in all groups of acute amitriptyline poisoning cases on supplementation with antioxidants. 5. The study shows only lower values of RBC Glutathione reductase activity on admission and increase in values on discharge for Group III and Group IV acute amitriptyline poison cases. 6. The average age of acute amitriptyline poisoning cases was 33 for male and 32 for female, and this study shows that the amitriptyline poisoning is seen more in male (55.3%) than female (44.7%). 7. The isoenzyme studies show that the increased LDH in Group A (ten cases were selected randomly among the groups only on admission for LDH and CPK study) and Group B (ten cases were selected randomly among the groups only on admission for LDH and CPK study) cases may be due to pulmonary infarction and may be moderately due to hepatic cell damage. 8. The increase of CK in acute amitriptyline poisoning cases in Group A and Group B are primarily due to pulmonary infarction not due to cardiac or skeletal muscle involvement

The Characteristic of Parents and Elementary School Students in Offline Learning during The Covid-19 Pandemic in Indonesia

Introduction: The government has issued a new policy to hold face-to-face meetings at schools in July 2021 following the decreased of positive confirmed cases of COVID-19 in children, increasing public discipline in health protocols implementation and most teachers have been vaccinated. However, the parents still worry about the spread of COVID-19 in school which creates anxiety for parents. Method: This study used a quantitative method with a cross-sectional survey approach. The population in this study were all parents of elementary school students (SD) in Indonesia. The sampling technique is non-probability sampling with a consecutive sampling approach where the researcher distributes the instrument online on social media. Data collection will be carried out in Sep – Nov 2022.Result: The majority of children who participated in offline learning were in grade 1-3 (76; 57.1%). The majority of education level of mothers (95; 70.9%) and fathers (95; 70.9%) were high education. Most of mothers (73; 54.5%) and fathers (103; 76.8%) had income more than three million rupiah. Most children participated in offline learning in July-December 2021 (85; 63.4%). Offline learning was held in 1-3 times a week (61; 45.5%) that occurs in 1-3 hours for day (68;50.7%). Conclusion: The implementation of offline learning is mostly held after June 2022, but there were several students who participated since 2020. There is variation of implementation offline learning from one to six days in a wee

Cultural-Based Diabetes Self-Care Management Education for People with Type 2 Diabetes Mellitus: Empowering Community Health Workers (Kaders) Program Evaluation

Aim: The aim of this study was to understand the perspectives of Kaders, community health nurses (CHNs), and the community on an empowerment program for Kaders in Indonesia. The program aimed to help Kaders provide cultural-based diabetes self-care management education for people with type 2 diabetes mellitus (T2DM). Methods: The empowerment program consisted of a four-month training program, including two full-day sessions on cultural-based health education for people with T2DM, followed by four months of monitoring T2DM patients. Fifteen Kaders from community health centers in Makassar City participated in the program. Focus group discussions (FGDs) were conducted with Kaders to explore their perceptions and experiences related to the program. Interviews were also conducted with CHNs and people with T2DM regarding their perceptions of the program. Results: The FGDs with Kaders resulted in four themes: overall training, guideline book, education and monitoring program, and potential obstacles. CHNs highlighted the benefits of the program, the guideline book, and the impact on patients. Patients identified three themes, including the benefits of the program, what was taught, and what was improved. Conclusion: The empowerment program for Kaders in Indonesia has proven to be beneficial for Kaders, CHNs, and the community. Kaders have the potential to provide effective and efficient health education with proper preparation and empowerment through knowledge and skills

Pengembangan Model Partisipasi Masyarakat dalam Penyelenggaraan Pemerintahan Desa di Kabupaten Banyumas

Diundangkannya UU No. 6 Tahun 2014 tentang Desa memberi peluang bagi pengembangan otonomi desa yang demokratis. Penelitian ini mengangkat dua permasalahan, yakni pertama bagaimana pelaksanaan partisipasi masyarakat desa dalam penyelenggaraan pemerintahan desa?, kedua bagaimanakah implikasi pelaksanaan Undang-Undang No. 6 Tahun 2014 tentang Desa terhadap pengembangan model partisipasi masyarakat dalam penyelenggaraan pemerintahan desa? Metode penelitian yuridis empiris. Penelitian dilakukan di tiga kecamatan yaitu Kecamatan Sumpiuh, Banyumas dan Gumelar. Hasil penelitian menunjukkan bahwa pertama, partisipasi masyarakat diwujudkan dalam bentuk interaksi langsung melalui rembug desa di tingkat RT, maupun melalui unsur keterwakilan seperti BPD, PKK. Kedua, partisipasi masyarakat mengarah pada bentuk keterwakilan, maka disarankan untuk dilakukan peningkatan kualitas SDM lembaga kemasyarakatan di desa