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Medical and health personnel have the potential to play an important role in triage START in the event of a disaster. However, it is important to have an instrument in evaluating the level of knowledge and attitudes of medical and health dragons regarding the START triage. This instrument is essential for the development of a comprehensive and efficient START triage education program for medical and health personnel. Therefore, this study aims to assess the accuracy and consistency of knowledge and attitude instruments in conducting START triage for medical and health personnel. A cross-sectional study involving 100 respondents. This instrument is created through a literature review. The instrument totaled 10 items of statements on knowledge and 10 items of statements on attitudes categorized into 6 groups: 1) disasters; 2) START triage; 3) START triage principle; 4) START triage indicator; 5) START triage implementation procedure. The results of this study showed 100 participants, the majority of whom were female with an average age of 36 years. All participants are medical and health personnel. The instruments used in the study were validated through content validity (Pearson Product Moment) and biserial correlation. Utilizing internal consistency reliability, the study found satisfactory inter-item reliability for all knowledge items (0.70 – 0.73) and attitude items (0.86 – 0.90). Conclusion: these findings suggest that knowledge and attitudes in performing the START triage are important for medical and health personnel

The incidence of type 2 diabetes mellitus is increasing in developing countries, including Indonesia. Insulin resistance is a significant contributor to elevated blood glucose levels in type-2 diabetes patients. Low levels of serum sirtuin-1, irisin, and vitamin D have been linked to insulin resistance. This study aimed to identify risk factors that could predict uncontrolled glycemia and insulin resistance in Indonesian type-2 diabetes patients. We conducted a cross-sectional study with 73 adults from South Jakarta, Indonesia, in which we examined type-2 diabetes risk factors and biomarkers, including sex, age, body mass index, waist circumference, waist–to–hip ratio, fasting blood glucose (FBG) levels, fasting insulin, sirtuin-1, irisin, and vitamin D levels. The subjects were categorized into two groups based on their glycated hemoglobin (HbA1c) level and homeostatic model assessment for insulin resistance (HOMA-IR) index to assess glycemic control and insulin resistance, respectively. We compared risk factor profiles between groups and analyzed multivariate relationships with logistic regression. Our findings revealed that 54 % of the subjects had uncontrolled glycemia, whereas only 11 % had insulin resistance. There was a significant association between uncontrolled glycemia and reduced sirtuin-1 levels (odds ratio = 4.07; p = 0.03), which was confirmed in the multivariate analysis (beta = 5.41, p = 0.014) along with FBG (beta = 36.88, p = 0.001). Irisin showed a marginal association with insulin resistance in both univariate (odds ratio = 0.12; p = 0.027) and multivariate analyses (beta = 0.09; p = 0.049). In conclusion, sirtuin-1, in addition to FBG, is a potential marker for assessing glycemic control in type-2 diabetes patients.

INTRODUCTION: Insulin resistance plays a central role in type 2 diabetes mellitus (T2DM). Another possible cause of T2DM is a deficiency of 25-hydroxy vitamin D [25(OH)D], although the underlying mechanism is not yet clearly understood. The most frequently used laboratory parameters for monitoring T2DM are fasting blood glucose (FBG) and HbA1c. Determining any association of vitamin D with HbA1c and FBG in T2DM. METHODS: A cross-sectional study involving 100 T2DM patients with the following characteristics: 18-year and older persons of both genders, not having kidney and liver disease, not on insulin therapy, not pregnant or lactating, and not consuming vitamin D in the last three months. Spearman’s correlation coefficient was used to test any association of 25(OH)D with HbA1c and fasting blood glucose (FBG) (p

Disasters due to earthquake natural events can have an impact on the community so that people who live in disaster-prone areas are the most disadvantaged parties. The community as a disadvantaged party must be equipped with disaster preparedness, one of which is a disaster risk reduction program. The purpose of this scooping review is to determine the description of the implementation of the earthquake disaster preparedness education and training program in the community. This research is a scooping review using Prisma flow chart in its implementation. The results of this study showed significant results in all articles (n=10) in improving community preparedness in earthquake disaster risk reduction. The methods used were the latest methods (virtual reality, animated videos, and games) and manual methods (lectures, discussions, and reading) with material on disaster concepts, management, and first aid. This research concludes that the role of the community and the importance of disaster preparedness education for the community is very important to be provided by conducting the latest or modern methods for more effective results.

BACKGROUND: 25(OH)D level is correlated with insulin secretion and tissue sensitivity to insulin. Administration of vitamin D supplements may reduce tissue resistance to insulin in type 2 diabetes mellitus (T2DM), but a number of studies found conflicting results. The present study was to measure the results of administration of vitamin D supplements for 3 and 6 months regarding HbA1c, fasting blood glucose (FBG), insulin and tissue resistance to insulin in T2DM cases. METHODS: A randomized double-blind placebo-controlled trial was conducted in T2DM patients with ≤3 years duration. Subjects were randomly divided into two groups: 47 subjects received daily 5000 IU vitamin D supplementation and 47 subjects received daily placebo as control. After supplementation for 3 and 6 months, homeostatic model assessment for tissue resistance to insulin (HOMA-IR), insulin, HbA1c, and FBG were examined. RESULTS: Supplementation of daily 5000 IU vitamin D for 3 months increased 25(OH)D level in the vitamin D group from 12.50±5.28 to 43.57±17.14 ng/mL, and after 6 months the 25(OH)D level was 38.38±17.64 ng/mL. Both groups showed significant differences after 3 and 6 months regarding HOMA-IR (p=0.033 and p=0.031), insulin (p=0.034 and p=0.013), but not FBG (p=0.296) and HbA1c (p=0.360). In both groups, HOMA-IR and insulin increased although the increase in the control group was greater than in the vitamin D group. The difference between the control and vitamin D groups was significant. CONCLUSION: Vitamin D supplementation for 3 and 6 months may lead to improvement HOMA-IR but not for FBG and HbA1c in the vitamin D group as compared with the control group in T2DM cases. KEYWORDS: vitamin D, T2DM, HbA1c, blood glucose, insulin, tissue resistance to insulin

Background: Glycated hemoglobin (HbA1c) has been used extensively to diagnose and monitor diabetes mellitus (DM). Patients with type 2 DM are at risk of experiencing comorbidities and complications such as iron deficiency anemia (IDA). This study aimed to determine the correlation of HbA1c with iron deficiency anemia (IDA) in type 2 DM. Methods: This cross-sectional study was conducted on 115 types 2 DM patients at a hospital in South Jakarta, Indonesia from November to December 2021. Data on HbA1c levels and IDA were obtained from medical records. Data were analysed with the Chi-Square test and significancy at p

Introduction: The prevalence of metabolic syndrome (MetS) in Indonesia is 39% and it is higher in females than in males (46% vs. 28%). Features of this syndrome comprise low-grade chronic inflammation and endothelial dysfunction from cardiometabolic abnormalities. High-sensitive C-reactive protein (HsCRP) is a biomarker of cardiovascular disease, whereas ferritin and pentraxin-3 (PTX-3) are markers of chronic inflammation. One of the markers of endothelial dysfunction is an intercellular cell adhesion molecule-1 (ICAM-1). Studies on MetS in women aged 50–70 years and using several markers of inflammation and endothelial dysfunction are rare. The study aimed to determine differences in HsCRP, ferritin, PTX-3, and ICAM-1 level between females with and without MetS aged 50–75 years. Methods: For this cross-sectional study, 160 females aged 50–75 years from South Jakarta were recruited, divided into MetS and non-MetS (control) groups, 80 participants each. Participants that met the inclusion criteria were assessed for vital signs and metabolic parameters (e.g., lipid profile, fasting blood glucose level, and waist circumference [WC]). The groups were compared using an independent t-test for inflammatory (i.e., HsCRP, PTX-3, and ferritin) and endothelial dysfunction (ICAM-1) (p < 0.05) biomarkers. Results: The mean age of the MetS and control groups was 59.6 ± 5.6 and 59.2 ± 5.5 years. MetS criteria included WC of ≥80 cm (95.2%), increased blood pressure level (90.6%); and high-density lipoprotein cholesterol of

In patients with type 2 diabetes mellitus (Type 2 DM), glycemic control plays an essential role in reducing macro- and microvascular complications. The earliest marker for diabetic nephropathy is the presence of albuminuria. Meanwhile, HbA1c has been recognized as a marker of glycemic control in the blood. This study aimed to identify the correlation between HbA1c and albuminuria in type 2 DM. This was a cross-sectional study involving 100 patients with type 2 DM aged 40–70 years visiting Dr. Soetomo Hospital, Surabaya, Indonesia. Secondary data from medical records of type 2 DM patients undergoing HbA1c and albuminuria examinations from January to December 2015 were used. The mean age of subjects was 55.4 ±8.7 years, with the majority (55%) being of female gender. The mean HbA1c concentration was 9.8±2.4%. Most subjects (83%) had an HbA1c level of ≥7 %. Albuminuria was found in the majority of the subjects (78%), where 33% of them had positive 1 albuminuria. The Spearman correlation test showed a positive strong significant correlation between HbA1c and albuminuria, with r=0.865 and p

Background: Uses of HbA1c compared with glycated albumin as an indicator of glycemic control for hemodialysis patients(HD) needs to be evaluated. HbA1c has some limitations when used for HD because its results can falsely low or falsely high. It can be missunderstood if clinicians use HbA1c as glycemic control. Objective: This study aimed to evaluate correlation between HbA1c and GA in HD patients with Diabetes Mellitus (DM). Methods: This study was a cross sectional study conducted on November 2016 until January 2017. Its samples were obtained from 43 patients in HD with DM, fullfilling inclusion and exclusion criteria, located in a private hospital at east Jakarta. The HbA1c was measured by using a turbidimetric inhibition immunoassay method, and the GA was measured by using an enzimatic colorimetric method. In addition, a test of Pearson correlation was used to determine the correlation between HbA1c and GA with a significance of p

Background Menopause is associated with changes in metabolic profile. Although hormone replacement therapy (HRT) has been shown to have beneficial effects on lipid metabolism, its adverse effects have indicated a need for alternative estrogen-based treatments. Several investigations have evaluated the effects of isoflavones on serum lipid levels in postmenopausal women, but the results were ambiguous. The objective of this study was to determine the relationship of dietary daidzein, genistein, and glycitein levels with lipid profile in postmenopausal women. Methods A cross-sectional study was conducted involving 186 post-menopausal women. A food recall questionnaire was used to measure dietary genistein, daidzein, and glycitein levels. Serum total cholesterol (TC), low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, and triacylglycerol (TAG) were measured using the enzymatic colorimetric method. Simple and multivariate linear regression were used to analyze the data. Results Genistein intake was significantly associated with TC (b=145.48, p=0.023) and HDL cholesterol levels (b=48.80, p=0.032). Daidzein intake was significantly associated with TC (b=-204.60, p=0.003), LDL cholesterol (b=-160.81, p=0.014) and HDL cholesterol levels (b=-67.118, p=0.032). Glycitein was not significantly associated with TC (b=232.78;p=0.133), HDL (b=43.59;p=0.428), and LDL (b=235.84;p=0.116). Dietary daidzein had a more lowering effect on TC (Beta=-2.80) and HDL cholesterol (Beta=-2.67) than had genistein on TC (Beta=2.66) and HDL cholesterol (Beta=2.03). Conclusions High dietary daidzein level has a significant lowering effect on TC, LDL cholesterol and HDL cholesterol in post-menopausal women. Our study supports the advice given to the public to increase soy isoflavone intake in post-menopausal women.

Background Diabetes mellitus (DM) is a metabolic disease with a large incidence in the world and constitutes a global health problem. By 2030 it is estimated that there will be around 439 million people suffering from DM. Diabetes mellitus is a metabolic disease caused by a lack or absence of the hormone insulin. In type 2 DM pharmacotherapy can be given one of which is insulin. To monitor therapy, random blood glucose, glycated hemoglobin (HbA1c) and glycated albumin (GA) levels can be examined. The objective of this study was to determine the relationship of glycated albumin and glycated hemoglobin (HbA1c) with random blood glucose in insulin-treated diabetics. Methods A cross-sectional study was conducted involving 92 type 2 diabetic patients treated with insulin. The study used a questionnaire and blood samples. We measured the GA , HbA1C and random blood glucose levels. A multiple linear regression was used to analyze the data. Results Mean HbA1c was 9.21 ± 2.15%, mean glycated albumin was 24.4 ± 8.65%, and mean blood glucose was 229.47 ± 98.7 mg/dL. Multiple linear regression tests showed that HbA1c (B= 5,544; â=0.121; p=0.420) and GA (B=5.899; â=0.517; p=0.001) was signigicantly corelated with random blood gucose, respectively, indicating that glycated albumin is significantly related to and has the greatest influence on glucose level. Conclusion Glycated albumin is correlated with and has greater influence on glucose level than does HbA1c. Glycated albumin could be a better marker for glycemic control than glycated hemoglobin in diabetic patients treated with insulin.

Background Sleep is needed by the human body so that the performance of body remains optimal when the body is awake, especially during work. Informal workers often work without clear regulations, with inadequate equipment and poor work environment, and pay little attention to occupational health and safety factors. The existence of large work demands with unclear work system arrangements will certainly result in a mental workload in these workers. The objective of this study was to determine the relationship between mental workload and sleep patterns of workers in the informal garment sector. Methods A cross-sectional study involving 225 informal garment workers was conducted between December 2018 and May 2019. Data collection included respondents’ demographics, job characteristics, measurement of mental burden and disturbances in sleep patterns. The sleep pattern used the PSQI (Pittsburgh Sleep Quality Index) instrument and the mental burden used the Rating Scale Mental Effort (RSME). A multiple linear regression analysis was used to analyze the data. Results The mean sleep quality was 5.40 ± 2.54. Multiple linear regression test found that mental workload correlated significantly with sleep quality of workers (β=0.016, p=0.012). Conclusion This study demonstrated that heavy mental workload decreases the quality of sleep in informal garment workers. A good work system management is required so that workers are assigned that portion of the task that is commensurate with their capacity.

Background One of the extra-skeletal roles of vitamin D for health is associated with cardiovascular disease. Poor vitamin D status has been associated with vascular endothelial dysfunction. There were controversial results about the association between vitamin D deficiency and matrix metalloproteinase 9 (MMP-9) concentration. The purpose of the present study was to determine the concentrations of 25(OH) vitamin D [25(OH)D] in an elderly population and to find any association between 25(OH)D and MMP-9 concentrations. Methods This study was of cross-sectional design involving 160 male and female subjects aged 55–65 years, in South Jakarta, Indonesia. Determination of MMP-9 and 25(OH)D concentrations was done concurrently on subjects who met the inclusion and exclusion criteria after all study subjects had been selected. 25(OH)D and MMP-9 concentrations were assessed by direct competitive chemiluminescence immunoassay (CLIA) and enzyme-linked immunosorbent assay (ELISA) respectively. Statistical analysis used chi square and t tests. Results Mean 25(OH)D concentration in the study subjects was 14.4 ± 6.4 ng/mL. A total of 68.8% of subjects had a 25(OH)D level of 20 ng/mL.There was an increased MMP-9 concentration in male subjects with a 25(OH)D level of 20 ng/mL (p=0.011), but not among female subjects (p=0.809). Conclusion The MMP-9 concentration was increased among male subjects with low level of (OH)D. This study confirmed that 25(OH)D concentration may have a potential role in endothelial function.

In premenopausal women cardiovascular disease is rarely encountered, but after menopause the prevalence of cardiovascular disease increases drastically. There are several risk factors for cardiovascular disease, known as traditional risk factors, among others body fat concentration, age, duration of menopause, body mass index (BMI), and estradiol concentration. Cardiovascular disease is considered as an inflammatory disorder, in which adhesion molecules play an important role. Vascular cell adhesion molecule-1 (VCAM-1) is one of the adhesion molecules with an important role in the atherosclerotic process. The aim of this study was to determine the relationship of risk factors affecting the expression of VCAM-1 in postmenopausal women. This study was a cross-sectional study involving 182 postmenopausal women in the age range of 47- 60 years, who were residents of Mampang Prapatan subdistrict, South Jakarta. Venous blood samples were obtained for laboratory investigations, viz. fasting blood glucose, total cholesterol, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, triglycerides, creatinine, serum glutamic oxaloacetic transamirase (SGOT), serum glutamic pyruvic transmirasi (SGPT), bilirubin, total protein, albumin, estradiol and vascular cell adhesion molecule-1 (VCAM-1).A multiple regression analysis was performed on traditional risk factors and their relationship with VCAM-1 concentration. The results showed there were five traditional risk factors influencing VCAM-1 concentration, viz. duration of menopause, BMI, estradiol concentration, HDL cholesterol, and LDL cholesterol. Among these five factors, LDL cholesterol had the greatest influence on VCAM-1 expression (beta coefficient = -0.253 and p=0.001). In conclusion, LDL cholesterol concentration decreased VCAM-1 expression in postmenopausal women.

Aging is associated with a gradual impairment in cognitive function. The elderly also show a high prevalence of undernutrition, whereas nutrition plays an important role in the metabolism of neuronal cells and enzymes. Homocysteine is an amino acid resulting from methionine metabolism and is dependent on intake of vitamin B12, vitamin B6 and folic acid. Homocysteine is said to play a role in cognitive function. The objective of this study was to evaluate the effect of micronutrient supplementation for 6 months on serum homocysteine levels and cognitive function in older people. This study was an experimental study of pre-post test design, carried out in Mampang subdistrict, South Jakarta. A total of 94 elderly people was recruited for this study, consisting of 44 females and 50 males. Serum homocysteine level was assessed by fluorescent polarization immunoassay and cognitive function by means of the mini mental state examination (MMSE) before and after micronutrient supplementation. Mean serum homocysteine concentration after supplementation decreased significantly to 14.8 ± 5.8 mmol/L, compared with mean serum homocysteine level of 15.9 ± 5.9 mmol/L before supplementation (p=0.000). Multiple regression analysis indicated that the factors influencing post-supplementation MMSE scores were gender (â=-0.350; p=0.000), education (â=0.510; p=0.000) and post-supplementation homocysteine levels (â=-0.201; p=0.000), while age, pre-supplementation homocysteine levels and BMI did not affect MMSE scores. Homocysteine concentration decreased significantly after 6 months of supplementation. The factors affecting post-supplementation MMSE scores were gender, level of education, and post-supplementation homocysteine level.

Dementia is prevalent among elderly people, and projections show that the number of affected might triple over the next 50 years, because of a large increase in the oldest segment of the population. The objective of this study was to investigate the relationship between cognitive function and serum homocysteine level. This study was a cross-sectional study carried out in Mampang district, South Jakarta. A total of 94 elderly people was recruited for this study consisting of 44 females and 50 males. In this study serum homocysteine level was assessed by fluorescent polarization immunoassay and cognitive function with the mini mental state examination (MMSE). In elderly women MMSE scores for plasma homocysteine concentrations of 14.9 mmol/L were 24.00 ± 3.68, 23.80 ± 6.51, and 20.80 ± 9.00 respectively, with p=0.000. In elderly men the MMSE scores for plasma homocysteine concentrations of 14.9 mmol/L were respectively 27.66 ± 2.06, 26.33 ± 3.79 and 24.03 ± 5.52 with p=0.008. Homocysteine concentrations of >14.9 mmol/L were more commonly found in males (66%) than in females (22.70%). The results of a regression analysis indicated that the factors influencing cognitive function were level of education (p=0.001) and age (p=0.035), whereas gender and homocysteine concentration did not affect cognitive function (p=0.554 and p=0.714, respectively). Plasma homocysteine concentration was inversely related to cognitive function. The most important factors affecting cognitive function were level of education and age.

Background The prevalence of diabetes in Indonesia continues to increase and causes many complications. Fruits of Phaleria macrocarpa (Scheff.) Boerl. (PM) are used in the traditional health system of the Indonesians, as effective remedy in the management of diabetes mellitus. The aim of this study was to evaluate the effect and magnitude of doses of PM dry fruit extract (PME) on blood glucose levels in healthy adults. Methods This research was of pre-posttest design involving 30 healthy volunteer subjects aged 20-55 years receiving glucose loads. At pre-test the subjects were given orally 75 g glucose, and at post-test they were given PME at doses of 125 mg and 250 mg. Data collection included anthropometric examination and blood glucose level. The area under the curve (AUC) of blood glucose levels was measured at 0, 15, 30, 60, 120 and 180 minutes. Data analysis was performed using paired t-test with p

Background Cardiovascular disease is the main cause of death in postmenopausal women. This study aimed at evaluating the effect of soy isoflavone supplementation on plasma lipid profile in postmenopausal women, since this effect is still unclear. Methods A double-blind randomized placebo-controlled trial was conducted from January 2010 until February 2011. In total 180 postmenopausal women were randomized into an isoflavone group and a control group of 90 subjects each. The isoflavone group received tablets containing 100 mg soy isoflavones and 500 mg calcium carbonate, while the control group received 500 mg calcium carbonate only. Supplementation was given once daily for 1 year. Plasma lipid levels [triacylglycerol, total, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) cholesterols] were assessed at baseline, and after 6 and 12 months of supplementation using an enzymatic colorimetric method (Cobas c 111, Roche). Independent t-test was used for data analysis. Results Baseline subject characteristics and lipid profile in the two groups were comparable. In the isoflavone and control groups after 6 months of supplementation LDL cholesterol levels were 124.9 ± 35.2 mg/dL vs 112 .7 ± 29.7 mg/dL (p=0.013*), respectively, and after 12 months 116.9 ± 31.7 mg/dL vs 109.1 ± 29.8 mg/dL (p=0.086). There were no significant differences in the other lipid levels at 6 and 12 months. Conclusions Soy isoflavone supplementation for 6 months was capable of significantly reducing LDL cholesterol levels in postmenopausal women. No significant changes in total cholesterol, triacylgycerol, and HDL cholesterol were found after isoflavone supplementation.

Reporting of the estimated glomerular filtration rate (GFR) in every creatinine test is suggested, despite the fact that every laboratory reports it in their result. Modification of Diet in Renal Disease (MDRD) is a formula that is used to estimate the GFR using serum creatinine. Serum cystatin C is a relatively new test and superior for assessing kidney functions. The purpose of this study was to show the correlation between MDRD and serum cystatin C. A cross-sectional study was conducted using secondary data from 260 subjects, aged 40–70 years old to assess serum creatinine and serum cystatin C at a private laboratory in West Jakarta, during the period of January 2013–September 2014. The result of the study showed that the mean age of subjects was 55.7+7.8 years old, the mean serum cystatin C level was 0.99 + 0.6 mg/L, and the mean MDRD was 80.24±28.1 mL/min/1.73 m2. Pearson correlation analysis showed a negative correlation between MDRD and serum cystatin C with r = -0.767 and p =0.001. In conclusion, higher MDRD presents lower cystatin C serum; hence, MDRD can be used as an alternative renal function test when serum cystatin C is not available. [

Background Vitamin D insufficiency is associated with obesity and central obesity, which is in turn associated with the accumulation of visceral fat. Visceral fat secretes adiponectin which has a role in the pathogenesis of the metabolic syndrome, diabetes mellitus and cerebrovascular disease. The aim of this study was to determine the relationship between serum 25-hydroxy vitamin D [25(OH)D] level and adiponectin level in adults with central obesity. Methods This study was a cross sectional study with 80 subjects with central obesity and 80 healthy subjects as controls. The age of the subjects ranged from 55 to 65 years. The data collection included anthropometry and blood biochemistry (lipid profile, fasting blood glucose, 25(OH)D, and adiponectin). The data were analyzed using independent t test with p

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Background Cardiovascular disease is the main cause of death in postmenopausal women. This study aimed at evaluating the effect of soy isoflavone supplementation on plasma lipid profile in postmenopausal women, since this effect is still unclear. Methods A double-blind randomized placebo-controlled trial was conducted from January 2010 until February 2011. In total 180 postmenopausal women were randomized into an isoflavone group and a control group of 90 subjects each. The isoflavone group received tablets containing 100 mg soy isoflavones and 500 mg calcium carbonate, while the control group received 500 mg calcium carbonate only. Supplementation was given once daily for 1 year. Plasma lipid levels [triacylglycerol, total, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) cholesterols] were assessed at baseline, and after 6 and 12 months of supplementation using an enzymatic colorimetric method (Cobas c 111, Roche). Independent t-test was used for data analysis. Results Baseline subject characteristics and lipid profile in the two groups were comparable. In the isoflavone and control groups after 6 months of supplementation LDL cholesterol levels were 124.9 ± 35.2 mg/dL vs 112 .7 ± 29.7 mg/dL (p=0.013*), respectively, and after 12 months 116.9 ± 31.7 mg/dL vs 109.1 ± 29.8 mg/dL (p=0.086). There were no significant differences in the other lipid levels at 6 and 12 months. Conclusions Soy isoflavone supplementation for 6 months was capable of significantly reducing LDL cholesterol levels in postmenopausal women. No significant changes in total cholesterol, triacylgycerol, and HDL cholesterol were found after isoflavone supplementation.

In premenopausal women cardiovascular disease is rarely encountered, but after menopause the prevalence of cardiovascular disease increases drastically. There are several risk factors for cardiovascular disease, known as traditional risk factors, among others body fat concentration, age, duration of menopause, body mass index (BMI), and estradiol concentration. Cardiovascular disease is considered as an inflammatory disorder, in which adhesion molecules play an important role. Vascular cell adhesion molecule-1 (VCAM-1) is one of the adhesion molecules with an important role in the atherosclerotic process. The aim of this study was to determine the relationship of risk factors affecting the expression of VCAM-1 in postmenopausal women. This study was a cross-sectional study involving 182 postmenopausal women in the age range of 47- 60 years, who were residents of Mampang Prapatan subdistrict, South Jakarta. Venous blood samples were obtained for laboratory investigations, viz. fasting blood glucose, total cholesterol, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, triglycerides, creatinine, serum glutamic oxaloacetic transamirase (SGOT), serum glutamic pyruvic transmirasi (SGPT), bilirubin, total protein, albumin, estradiol and vascular cell adhesion molecule-1 (VCAM-1).A multiple regression analysis was performed on traditional risk factors and their relationship with VCAM-1 concentration. The results showed there were five traditional risk factors influencing VCAM-1 concentration, viz. duration of menopause, BMI, estradiol concentration, HDL cholesterol, and LDL cholesterol. Among these five factors, LDL cholesterol had the greatest influence on VCAM-1 expression (beta coefficient = -0.253 and p=0.001). In conclusion, LDL cholesterol concentration decreased VCAM-1 expression in postmenopausal women.

Aging is associated with a gradual impairment in cognitive function. The elderly also show a high prevalence of undernutrition, whereas nutrition plays an important role in the metabolism of neuronal cells and enzymes. Homocysteine is an amino acid resulting from methionine metabolism and is dependent on intake of vitamin B12, vitamin B6 and folic acid. Homocysteine is said to play a role in cognitive function. The objective of this study was to evaluate the effect of micronutrient supplementation for 6 months on serum homocysteine levels and cognitive function in older people. This study was an experimental study of pre-post test design, carried out in Mampang subdistrict, South Jakarta. A total of 94 elderly people was recruited for this study, consisting of 44 females and 50 males. Serum homocysteine level was assessed by fluorescent polarization immunoassay and cognitive function by means of the mini mental state examination (MMSE) before and after micronutrient supplementation. Mean serum homocysteine concentration after supplementation decreased significantly to 14.8 ± 5.8 mmol/L, compared with mean serum homocysteine level of 15.9 ± 5.9 mmol/L before supplementation (p=0.000). Multiple regression analysis indicated that the factors influencing post-supplementation MMSE scores were gender (â=-0.350; p=0.000), education (â=0.510; p=0.000) and post-supplementation homocysteine levels (â=-0.201; p=0.000), while age, pre-supplementation homocysteine levels and BMI did not affect MMSE scores. Homocysteine concentration decreased significantly after 6 months of supplementation. The factors affecting post-supplementation MMSE scores were gender, level of education, and post-supplementation homocysteine level.

Dementia is prevalent among elderly people, and projections show that the number of affected might triple over the next 50 years, because of a large increase in the oldest segment of the population. The objective of this study was to investigate the relationship between cognitive function and serum homocysteine level. This study was a cross-sectional study carried out in Mampang district, South Jakarta. A total of 94 elderly people was recruited for this study consisting of 44 females and 50 males. In this study serum homocysteine level was assessed by fluorescent polarization immunoassay and cognitive function with the mini mental state examination (MMSE). In elderly women MMSE scores for plasma homocysteine concentrations of 14.9 mmol/L were 24.00 ± 3.68, 23.80 ± 6.51, and 20.80 ± 9.00 respectively, with p=0.000. In elderly men the MMSE scores for plasma homocysteine concentrations of 14.9 mmol/L were respectively 27.66 ± 2.06, 26.33 ± 3.79 and 24.03 ± 5.52 with p=0.008. Homocysteine concentrations of >14.9 mmol/L were more commonly found in males (66%) than in females (22.70%). The results of a regression analysis indicated that the factors influencing cognitive function were level of education (p=0.001) and age (p=0.035), whereas gender and homocysteine concentration did not affect cognitive function (p=0.554 and p=0.714, respectively). Plasma homocysteine concentration was inversely related to cognitive function. The most important factors affecting cognitive function were level of education and age.

Sudah diketahui secara luas bahwa seseorang dengan obesitas mempunyai risiko tinggi untuk mengalami resistensi insulin dan komplikasi metaboliknya seperti diabetes melitus tipe 2 (T2DM), hipertrigliseridemia, penurunan kolesterol high density lipoprotein, hipertensi dan penyakit kardiovaskuler. Akumulasi jaringan adiposa pada bagian tertentu di tubuh seperti di rongga perut menyebabkan peningkatan risiko terjadinya resistensi insulin sampai terjadinya sindroma metabolik. Sindroma metabolik merupakan suatu abnormalitas metabolik yang melibatkan berbagai faktor yang saling berkaitan serta merupakan faktor risiko penyakit jantung koroner yang paling penting pada populasi modern. Pengaturan produksi adipositokin berperan penting pada homeostasis metabolisme glukosa dan lipid. Disregulasi produksi adipositokin pada obesitas sentral terlibat langsung pada patogenesis sindroma metabolik. Penurunan berat badan atau pencegahan peningkatan berat badan merupakan cara terbaik mencegah terjadinya obesitas terutama obesitas sentral yang juga merupakan suatu cara mencegah terjadinya T2DM. Edukasi mengenai komplikasi obesitas dan keterlibatan keluarga dalam pengobatan T2DM sangat penting.

Purpose: This study aims to examine various factors influencing the inclination of students toward Green Entrepreneurial Intention (GEI), including University Support (USP), Family Support (FSP), Religiosity (REL), Commitment to Environment (CEN) and Green Entrepreneurial Motivation (GEM), as well as Attitude towards Green Entrepreneurship (AGM). Design/methodology/approach: Data were collected through an online survey of Muslim students at Indonesian Islamic universities. A five-point Likert scale was used in the online questionnaire, with 419 processed data. Partial least squares structural equation modeling was used to analyze the data and test the relationship between the variables. Findings: The results showed that AGM, CEN and REL impacted GEM. AGM was influenced by FSP but not by USP while GEI was significantly influenced by AGM, FSP and USP. Research limitations/implications: The limitation of the study is the composition of the sample, consisting solely of Islamic university students. Another limitation is the variables used. Future studies should analyze other factors, such as role models, green knowledge or family background. Practical implications: This study provided fresh perspectives by empirically establishing a framework for assessing GEI, considering REL variables, an unexplored area conceptually. Practically, it helped to advance sustainable entrepreneurship education, particularly in Islamic universities. Accordingly, it provided several practical contributions for universities to develop curricula that better support green entrepreneurship among students. Originality/value: This study represented the first investigation into the influence of REL on GEI, specifically among university students. Furthermore, Stimuli, Organism and Response theory was used as a foundation for the development of the diverse variables under investigation. [ABSTRACT FROM AUTHOR]

This study explores the factors influencing the use of microlearning in the public sector by applying the DeLone and McLean Information Systems Success Model (DMISM). The study focuses on the role of overall quality, compatibility, and transformational leadership in shaping the actual use of microlearning systems. Using a quantitative approach, data were collected from 317 employees of Indonesian Government Financial Institutions (Lembaga Keuangan Pemerintah) through an online survey. The data were analyzed using covariance-based structural equation modeling (CB-SEM) in LISREL 8.8. The results indicate that overall quality, compatibility, and transformational leadership have significant and positive impacts on the actual use of microlearning systems. Among these factors, compatibility emerged as the strongest predictor of use. The findings suggest that improving the quality of microlearning content, aligning it with employee preferences, and developing a supportive leadership environment are key to increasing the adoption and effectiveness of micro-learning in public sector organizations. Further research is recommended to explore other potential factors and expand the scope to other government sectors.. [ABSTRACT FROM AUTHOR]

This study aims to find out the strategies of English teachers in teaching writing for high school students. This research was conducted in one of the high schools in Karawang, the subject in this study was one grade 10 English teacher. This research is a qualitative research, to collect researcher data using observation and interviews. The results of the analysis showed that teachers applied the Collaborative Learning strategy, which encourages students to collaborate in groups to complete writing tasks, as well as the Multimedia-Based learning (MBL) strategy, which involves the use of media such as videos and PowerPoint presentations to support students' understanding of recount text material. The use of collaborative strategies has proven to be effective in increasing student engagement and understanding through discussion and sharing of ideas. Meanwhile, multimedia-based media helps students understand concepts visually and interactively. The findings of this study show that teachers use Collaborative Learning and Multimedia-Based learning (MBL) strategies to teach writing recount texts. In conclusion, the implementation of this strategy provides positive results in learning to write recount texts, by increasing student engagement and understanding comprehensively. [ABSTRACT FROM AUTHOR]

Violence experienced by adolescents has an impact on them both in terms of personality and the way they view life. This study aims to find out how the lives of adolescents who experience family violence become meaningful. The research method in the study used a qualitative approach with a phenomenological research type. Participants were selected using a purposive sampling system with data collection methods in the form of in-depth interviews with five participants. The results showed that adolescents who were victims of violence by their parents interpreted life in various ways. They lose trust in others and see life as a struggle for survival. They no longer identify their parents as parental figures. Teenagers see parents as threatening and insecure. Adolescent victims of violence fill their lives with sadness because they do not get affection, and they want freedom from their parents. This study concludes that adolescents who experience violence tend to try hard to survive the hard life they get. The findings of this study underscore the profound impact of family violence on adolescents' perceptions of their lives and interpersonal relationships. Understanding these experiences is critical to developing targeted interventions and support systems aimed at reducing the long-term effects of violence. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to investigate and evaluate the impact of person-organization fit (POF), person-job fit (PJF), and person-group fit (PGF) on turnover intention through job satisfaction (JS) in startup companies. Startup companies play an important role in society and the global economy. Design/Methods/Approach: Data was gathered through an online survey of workers in startup businesses, with 449 data. The analytical method used in this study was LISREL's Structural Equation Modelling (SEM) analysis to examine the relationship between employee fit, such as person-organization fit, person-job fit, and person-group fit, on turnover intention, mediated by job satisfaction. Findings: The findings show that job satisfaction is positively and significantly impacted by person-organization fit, person-job fit, and person-group fit. Job satisfaction was found to fully mediate the effect of person-organization fit, person-job fit, and person-group fit on turnover intention. Originality: Limited research focuses on startup companies, so this study is unique. There is still a need for more research on person-group fit, as most research has focused on person-organization fit and person-job fit. Practical implication: In order to create and maintain job satisfaction among employees, companies can create an environment that encourages open and transparent communication within companies, letting employees freely express their thoughts, ideas, and concerns. Furthermore, prioritizing work-life balance by offering flexible work schedules is critical to increasing job satisfaction. Then, they should align with their values, provide rewards, provide effective supervision, and foster a positive work environment. This is crucial to reduce turnover intention in startup companies. [ABSTRACT FROM AUTHOR]

Since beliefs and emotions are involved in teachers’ daily professional life, this case study aimed to reveal the beliefs of pre - service teachers (PST) emotional strategies and the reasons underlying their beliefs during teaching practicum. Six PSTs from three Indonesian universities who conducted teaching practicum in three different school areas participated in this study. Fruitful data were gained from classroom observations, in -depth interviews, and journal entries. The findings reveal that Indonesian PSTs believe designing both a lesson plan and a second one is significant in preparing the classroom situation appropriately for students. These strategies can improve their self-confidence and motivation and help them regulate down emotions to respond to spontaneous incidents. They also believe in cognitive strategies that the students' problems and the teacher's weaknesses provoke the students' misbehavior. To up -positive emotion regulation, they believe in fake strategies showing their excitement and enthusiasm in teaching through verbal and nonverbal cues. However, hiding and avoiding emotions are not suitable due to harmful impacts. Hence, teachers have to unveil their emotions in appropriate situations. Teachers' attention to all students is pivotal for learning and growth. Thus, PSTs' emotional competence must be enhanced, for they have the ability to identify, analyze, regulate, and express emotions in the proper context and situation. The teacher education program must give PSTs full support by including emotional competence as one of the subjects or a part of the course contents to promote positive beliefs on emotion regulation. [ABSTRACT FROM AUTHOR]

A doctor's legal responsibility is a doctor's "relationship" to legal provisions in carrying out his profession. The responsibility of a doctor in the field of law is divided into three parts, namely the responsibility of a doctor in the field of civil law (Articles 1365, 1366, 1426) criminal, (Article 322, Article 351, Article 356 of the Criminal Code regarding abuse, Article 359, Article 360, and Article 378 of the Criminal Code regarding acts of fraud and ethical responsibility. Legal protection for patients in health services claiming their rights as regulated in Article 276 of the Health Law, can claim compensation for health workers and/or health providers who cause losses due to errors or negligence of doctors. The research method used in this study is a normative research method using various types of primary legal materials in the form of laws and regulations and secondary legal materials in the form of literature materials related to the legal responsibility of doctors in health services as a source of research materials. [ABSTRACT FROM AUTHOR]

Diabetic kidney disease (DKD) is a long-term complication of diabetes mellitus (DM). The gold standard for diagnosis of DKD is kidney biopsy, but it is difficult to perform. Several clinical conditions have found an association between higher ANGPTL4 plasma levels in DKD. Angiopoeitin Like 4 (ANGPTL4) is a glycoprotein that regulates lipid and glucose metabolism, mediates proteinuria and is involved in glomerular disease. Studies have found ANGPTL4 levels to be elevated in diabetic conditions. Objective: To investigate the role of serum ANGPTL4 as a marker for early detection of DKD. Methods: A total of 87 patients with Type 2 DM were analysed using an observational analytic method with a crosssectional design. The study subjects were divided into DKD and non DKD groups, then serum ANGPTL4 was measured using the sandwich ELISA method. Furthermore, ANGPTL index cutoff was determined. Several other variables including glycemic control, duration of DM, history of hypertension, and dyslipidemia were analysed for their association with DKD and non DKD groups. The study continued by conducting multivariate analysis with logistic regression. Results: A total of 23 (26.4%) subjects were classified as DKD and 64 (73.6%) subjects as non DKD. ANGPTL cutoff determination of 16.64 ng/mL had a sensitivity and specificity of 87% and 51.6%, respectively. Bivariate analysis showed glycaemic control, duration of DM, and serum ANGPTL4 (p=0.044; p=0.009; p=0.014) were associated with the incidence of DKD. Multivariate analysis showed that serum ANGPTL4 with a cutoff of >16.64 ng/mL could be used as an independent predictor of DKD incidence with an adjusted OR of 6.73 (95%CI= 1.79-25.30; p=0.005). Conclusion: serum ANGPTL4 is an independent predictor of DKD. Suggestion: Urine sampling for UACR examination twice, periodic examination of serum ANGPTL4 levels to assess the progressiveness of DKD. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Governance & Administrative Reform is the property of Universitas Airlangga and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: This study investigates the impact of government and economic policy uncertainty (EPU) on companies' business operations, especially risk-taking tendencies and corporate financial reporting quality (FRQ). Design/methodology/approach: The study employs the generalised least squares regression model. The final sample comprised 27,376 company-year observations from eight countries in the Asia-Pacific region. Findings: EPU has a negative and significant effect on investment activity and FRQ. Higher EPU leads to a decline in investment and FRQ. Research limitations/implications: There are several limitations in this study. First, the authors used abnormal investments to measure investments, without considering the degree of irreversibility investment objectives. Second, although control variables are included at the company and country levels, they may only partially control for companies' mitigation effects. Third, the sample is limited to developing countries with unique characteristics in Asia-Pacific; therefore, the findings cannot be generalised. Practical implications: The findings can help investors, analysts and regulators evaluate EPU's impact on companies' business activities by offering an overview regarding the decline in investment efficiency and FRQ. The results can also be used as input for regulators in formulating policies that encourage companies to regulate investment levels without harming other stakeholders and maintain FRQ during periods of uncertainty. Originality/value: This research provides intriguing insights into EPU's effects on companies' investment activity and FRQ in developing countries, which are sensitive to changes in macroeconomic conditions. [ABSTRACT FROM AUTHOR]

Copyright of Jurnal Manajemen dan Organisasi is the property of IPB University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Jurnal Manajemen dan Organisasi is the property of IPB University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)