Preparasi Dan Karakterisasi Nanosuspensi Dengan Polivinilpirolidon (PVP) Sebagai Pembawa Nanopartikel Senyawa Asam Mefenamat

Several methods and technologies to increasing the solubility and dissolution rate of adrug substance has been successfully developed, such as forming of a complexingcompound, salt preparation, adjusting the pH, making of solid dispersions, etc. Oneof the technologies that are being developed is nanoparticle technology. Micronizationof drug that is processed to produce particles with nano-size. This research aims tocreate and characterize nanosuspension with Polyvinylpyrrolidone (PVP) as thevehicle of mefenamic acid nanoparticles using vibrating mill and ultrasound equipment.Nanosuspension obtained was characterized by optical microscope and PSA toperform optimization nanosuspension formed. The result of characterization showedthat the nanosuspension have an average diameter is 623.9 nm. Then, nanosuspensionof mefenamic acid was freeze drying. Nanosuspension and bulk of mefenamic acidwere characterization by XRD and put in a hard capsule shell for dissolution test.Profile of dissolution test with tris buffer media indicates that nanosuspension ofmefenamic acid has a pattern of drug release is slower and constant compared with themefenamic acid. bulk

Psychosocial and cultural reasons for delay in seeking help and nonadherence to treatment in Indonesian women with breast cancer: A qualitative study.

Objective: The aim of this study was to explore reasons for delay in seeking medical help and nonadherence to treatment in Indonesian women with breast cancer. Method: Semistructured interviews were conducted by purposive sampling, using a consecutive sample of 50 breast cancer patients who were treated at the Outpatient Surgical Oncology Clinic of Hasan Sadikin Hospital in Bandung, Indonesia. Interviews were recorded, transcribed verbatim, and coded using qualitative software. Codes were merged into main themes that were subsequently mapped onto the study's aim. Results: Eight main themes concerning reasons for delay in seeking medical help and treatment nonadherence emerged, namely: lack of awareness and knowledge, cancer beliefs, treatment beliefs, financial problems, emotional burden, severe side effects, paternalistic style of communication, and unmet information needs. Conclusion: This study has identified several modifiable psychosocial and cultural factors related to delay in seeking help and nonadherence to treatment in breast cancer patients. We suggest that the provision of extensive information through media campaigns, treatment decision aids, and caregiver and patient education are needed to change the illness behaviors of Indonesian breast cancer patients. © 2013 American Psychological Association

The Associations between Depression and Anxiety, and Quality of Life of Males with Infertily

Background: Earlier studies have reported that anxiety and depressive symptoms have a significant and negative impact on quality of life. Empirical studies on this research question, however, are lacking in Indonesia. This study aimed to examine the associations of depression and anxiety with quality of life of males with infertility. Subject and Methods: This was a cross-sectional study conducted at a private hospital in Semarang, Central Java. A sample of 213 men with infertility was selected for this study. The dependent variable was quality of life. The independent variables were depression and anxiety. Infertility data were obtained from the medical record. Quality of life was measured by fertility quality of life (FertiQol). Depression and anxiety were measured by hospital anxiety and depression scale (HADS). Strength of correlation was measured by Spearman correlation coefficient. Results: Depression and anxiety were correlated with all domains in the quality of life of males with infertility. Conclusion: Depression and anxiety are correlated with all domains in the quality of life of males with infertility. Keywords: quality of life, FertiQol, depression, anxiety, male, infertilit

Quality of life and health status of Indonesian women with breast cancer symptoms before the definitive diagnosis

__Objectives__ Breast cancer (BC) is prevalent in low and middle-income countries (LMICs) where the majority of cases are diagnosed in late stages. The aims of this study were: (1) to assess quality of life (QOL) and health status of Indonesian women with BC symptoms before definitive diagnosis; (2) to compare QOL and health status between women with BC symptoms before definitive diagnosis and Indonesian women in general; (3) to evaluate the association between demographic variables (age, residence, social economic status and education level) and QOL within the Indonesian women with BC symptoms before definitive diagnosis. __Methods__ We used WHOQOL-BREF to measure QOL and EQ-5D-5L for health status. Multivariate analysis of covariance (MANCOVA) was used to compare QOL and health status between women with BC symptoms and women from the general Indonesian population in order to control for confounders. Regression analyses were used for testing the association between the demographic variables, QOL, and health status. __Results__ In comparison with the data from the women from the general population (n = 471), the women with BC symptoms (n = 132) reported lower QOL, especially in physical and psychological domains. They also reported more problems in all dimensions of health status. Higher education and monthly income were positively associated with QOL and health status among the women with BC symptoms. __Conclusion__ Before receiving a definitive diagnosis, women who visit hospitals with symptoms of BC, report a lower QOL and health status than women in general. Our results suggest that healthcare providers should provide targeted strategies for women with BC symptoms to improve their QOL

Employing quality control and feedback to the EQ-5D-5L valuation protocol to improve the quality of data collection

Objectives: In valuing health states using generic questionnaires such as EQ-5D, there are unrevealed issues with the quality of the data collection. The aims were to describe the problems encountered during valuation and to evaluate a quality control report and subsequent retraining of interviewers in improving this valuation. Methods: Data from the first 266 respondents in an EQ-5D-5L valuation study were used. Interviewers were trained and answered questions regarding problems during these initial interviews. Thematic analysis was used, and individual feedback was provided. After completion of 98 interviews, a first quantitative quality control (QC) report was generated, followed by a 1-day retraining program. Subsequently individual feedback was also given on the basis of follow-up QCs. The Wilcoxon signed-rank test was used to assess improvements based on 7 indicators of quality as identified in the first QC and the QC conducted after a further 168 interviews. Results: Interviewers encountered problems in recruiting respondents. Solutions provided were: optimization of the time of interview, the use of broader networks and the use of different scripts to explain the project’s goals to respondents. For problems in interviewing process, solutions applied were: developing the technical and personal skills of the interviewers and stimulating the respondents’ thought processes. There were also technical problems related to hardware, software and internet connections. There was an improvement in all 7 indicators of quality after the second QC. Conclusion: Training before and during a study, and individual feedback on the basis of a quantitative QC, can increase the validity of values obtained from generic questionnaires

Non-adherence in Indonesian women with breast cancer and its determinants

Passchier, J. [Promotor]Sadarjoen, S.S. [Promotor]Klerk, C. de [Copromotor

The 21 February 2005, catastrophic waste avalanche at Leuwigajah dumpsite, Bandung, Indonesia

International audienceOn 21 February 2005 the Leuwigajah dumpsite, Bandung (Java, Indonesia) was affected by a largeslide after heavy rainfalls. Second deadliest waste slide in history, it buried 71 houses and killed 143 people.Amongst the contemporary disastrous events of this type, only a few have been documented. We explored failurepreconditions, triggering mechanisms and local context that conducted to this disaster. We carried on four fieldinvestigations on the site. A series of aerial photographs were acquired and completed by topographical measureson the ground. The morphology of the slide and its trajectory were reconstructed. To constrain the movementcondition, we studied the internal structure of the source area and realized surveys among stakeholders of thedumpsite and citizen.Results: 2.7 10 6 m3 of waste materials spread 1000 m from the source in a rice field with an average thickness of10 m. The material displays a preferential fabric parallel to the previous topography. Numerous internal slip surfaces,underlined by plastic bags explain the low friction coefficient. The presence of methane within the waste dumpwas responsible for explosions prior to sliding and for the fire that affects whole sliding mass.Conclusions: Resulting of a combination of heavy rainfall and consecutive explosions due to biogas suddenrelease, this disaster was predictable in reason ofi) a front slope of the dump of about 100% before the failure;ii) a poor dumpsite management;iii) the extreme vulnerability of the marginalized scavengers living at risk at the foot of the instable dump

PENGELOLAAN UMKM DALAM INDUSTRI KELAPA: ANALISIS PRAKTIK KEUANGAN, PRODUKSI, DAN PEMASARAN MELALUI EKSKURSI MAHASISWA MAGISTER AKUNTANSI UNIVERSITAS SANGGA BUANA YPKP BANDUNG DI PT PACIFIC EASTERN COCONUT UTAMA

Penelitian ini menganalisis pengelolaan Usaha Mikro, Kecil, dan Menengah (UMKM) dalam industri kelapa melalui ekskursi mahasiswa Magister Akuntansi Universitas Sangga Buana YPKP Bandung di PT Pacific Eastern Coconut Utama (PECU). Kelapa, sebagai komoditas unggulan Indonesia, memberikan kontribusi besar terhadap perekonomian dan kesejahteraan masyarakat, terutama melalui produk turunan yang bernilai tinggi. Tujuan penelitian ini adalah untuk mengidentifikasi praktik manajemen keuangan, produksi, dan pemasaran di PT PECU, serta tantangan yang dihadapi oleh UMKM di sektor kelapa. Melalui analisis SWOT, penelitian ini menemukan bahwa PT PECU memiliki kekuatan dalam kemitraan dengan 1.300 petani, fokus pada produk bernilai tambah, dan orientasi ekspor. Namun, perusahaan juga menghadapi kendala terkait ketergantungan bahan mentah, persaingan global, dan manajemen keuangan. Peluang pengembangan produk inovatif dan pemanfaatan teknologi juga teridentifikasi, meskipun ancaman seperti fluktuasi harga komoditas dan perubahan iklim harus diantisipasi. Ekskursi ini memberikan wawasan praktis mengenai pengelolaan UMKM yang dapat menghubungkan teori dengan praktik di lapangan, serta memberikan solusi terhadap tantangan yang dihadapi oleh UMKM dalam industri kelapa. Diharapkan, hasil penelitian ini dapat memperkuat pemahaman mahasiswa mengenai pengelolaan UMKM di sektor agroindustri dan memberikan kontribusi pada pengembangan strategi bisnis berkelanjutan bagi UMKM di Indonesia

Consulting a traditional healer and negative illness perceptions are associated with non-adherence to treatment in Indonesian women with breast cancer

Objective: The aim of the present study was to test the association between psychosocial factors and delay in uptake of treatment and treatment non-adherence in Indonesian women with breast cancer. Methods: Seventy consecutive patients with breast cancer who were treated at the Hasan Sadikin Hospital in Indonesia were recruited. They completed a demographic form, the non-adherence questionnaire, the Breast Cancer Knowledge Test, the Brief Illness Perception Questionnaire, the Multidimensional Health Locus of Control Scales, the Satisfaction with Cancer Information Profile and the Distress Thermometer. Results: Seventeen (24%) out of 70 patients reported that they had delayed initiating treatment at the hospital, and nine (13%) out of 70 patients had missed two or more consecutive treatment sessions. In the bivariate analyses, we found no significant differences on any of the psychological variables between patients who delayed initiating treatment and those patients who did not, whereas patients who had missed two or more consecutive sessions had lower satisfaction with the type and timing of information provided and more negative illness perceptions than patients who had not missed their sessions. In multivariate regression analyses, consulting a traditional healer before diagnosis was associated with treatment delay (β = 1.27, p = 0.04). More negative illness perceptions (β = 0.10, p = 0.02) and whether a traditional healer had been consulted after diagnosis (β = 1.67, p = 0.03) were associated with missing treatment sessions. Conclusions: Indonesian health professionals need to be aware of patients' negative illness perceptions and their unrealistic belief in traditional healers

Emotional Distress is Associated with Lower Health-Related Quality of Life Among Patients with Diabetes Using Antihypertensive and/or Antihyperlipidemic Medications:A Multicenter Study in Indonesia

Objective: To evaluate the associations between different types of diabetes distress and health-related quality of life (HRQOL) among patients with type 2 diabetes (T2DM) using antihypertensive and/or antihyperlipidemic medications in Indonesia and to explore the differences between those using only antihypertensive, only antihyperlipidemic, or both medications. Methods: A multicenter cross-sectional study was conducted in Community Health Centers in three cities in Indonesia among patients with T2DM aged at least 18 years who were using antihypertensive and/or antihyperlipidemic medications. Diabetes distress subscales (emotional, regimen-related, interpersonal, and physician-related distress) and HRQOL were assessed using a validated diabetes distress scale-17 and EQ-5D-5L scale, respectively. Multiple linear regression models were used to evaluate the associations between different types of diabetes distress and HRQOL adjusting for confounders. Results: Most of the 503 participants were females (67.6%) and aged 60-69 years (40.8%). Emotional distress was negatively associated with HRQOL among the whole group of patients (β: -0.08; 95% confidence interval (CI): -0.10, -0.05; p < 0.001). This association was similar across all therapeutic subgroups. Regimen-related distress (β: -0.06; 95% CI: -0.09, -0.03; p < 0.001) and interpersonal distress (β: -0.02; 95% CI: -0.05, -0.01; p = 0.022) were negatively associated, whereas physician-related distress (β: 0.04; 95% CI: 0.01, 0.07; p = 0.037) was positively associated with HRQOL among the whole group. These associations were also observed among those using only antihypertensive medication. Conclusion: Emotional distress affects HRQOL in T2DM patients treated for cardiovascular comorbidities, independent of antihypertensive and/or antihyperlipidemic medication use