Impaired health-related quality of life due to elevated risk of developing diabetes: A cross-sectional study in Indonesia.

BACKGROUND: This study investigated the association between elevated risk of developing diabetes and impaired health-related quality of life (HRQoL) in the Indonesian population. METHODS: A cross-sectional study was conducted on 1,336 Indonesians from the general population who had no previous diagnosis of diabetes. Utility score to represent HRQoL was measured using the EuroQol 5-dimension, while the risk for developing diabetes was determined using the Finnish Diabetes Risk Score (FINDRISC) instrument. All participants underwent a blood glucose test after fasting for 8 hours. The association between FINDRISC score and HRQoL adjusted for covariates was analysed using multivariate Tobit regression models. Minimal clinically important differences were used to facilitate interpretation of minimal changes in utility score that could be observed. RESULTS: The median (interquartile range) of the overall FINDRISC score was 6 (7), while the mean (95% confidence intervals) of the EQ-5D utility score was 0.93 (0.93-0.94). Once adjusted for clinical parameters and socio-demographic characteristics, participants with a higher FINDRISC score showed a significantly lower HRQoL. No significant association was detected between fasting blood glucose level categories and HRQoL. A difference of 4-5 points in the FINDRISC score was considered to reflect meaningful change in HRQoL in clinical practice. CONCLUSION: An elevated risk of developing diabetes is associated with a lower HRQoL. Therefore, attention should be paid not only to patients who have already been diagnosed with diabetes, but also to members of the general population who demonstrate an elevated risk of developing diabetes. This approach will assist in preventing the onset of diabetes and any further deterioration of HRQoL in this segment of the Indonesian population.

The knowledge mapping of HIV/AIDS in Indonesians living on six major islands using the Indonesian version of the HIV-KQ-18 instrument.

Indonesia's total number of HIV/AIDS cases is still high. Inadequate knowledge about the risk of HIV infection will influence HIV prevention and therapy. This study aimed to map the level of HIV-related knowledge among Indonesians living on six major islands in Indonesia and investigate the relationship between socio-demographic characteristics and HIV/AIDS knowledge. This cross-sectional study used the Bahasa Indonesia version of the HIV Knowledge Questionnaire-18 items (HIV-KQ-18) Instrument. Data collection was done online through the Google form application. A total of 5,364 participants were recruited. The participants from Java had the highest degree of HIV/AIDS knowledge, which was 12.5% higher than participants from Sumatra, Kalimantan, Sulawesi, Papua, and Maluku. Linear regression showed that region, educational level, monthly expenditure, occupation, background in health sciences, and workshop attendance were significantly correlated with HIV knowledge. Participants typically understand that "HIV/AIDS transmission" only happens when sex partners are changed. Additionally, the government still needs improvement in HIV/AIDS education, particularly in the HIV incubation period, HIV transmission from pregnant women to the fetus, and condom use as one method of protection. There are disparities in HIV/AIDS knowledge levels among the major islands of Indonesia. Based on these findings, the government's health promotion program to increase public awareness of HIV/AIDS must be implemented vigorously. Additionally, in line with our research findings, it is essential to broaden the scope of HIV/AIDS education and promotion materials.

Aromatic biomass (torch ginger) leaf-derived three-dimensional honeycomb-like carbon to enhance gravimetric supercapacitor.

BACKGROUND: Porous carbon electrode (PCE) is identified as a highly suitable electrode material for commercial application due to its production process, which is characterized by simplicity, cost-effectiveness and environmental friendliness. PCE was synthesized using torch ginger (Etlingera elatior (Jack) R.M. Smith) leaves as the base material. The leaves were treated with different concentrations of ZnCl2 , resulting in a supercapacitor cell electrode with unique honeycomb-like three-dimensional (3D) morphological pore structure. This PCE comprises nanofibers from lignin content and volatile compounds from aromatic biomass waste. RESULTS: From the characterization of physical properties, PCE-0.3 had an impressive amorphous porosity, wettability and 3D honeycomb-like structural morphology with a pore framework consisting of micropores and mesopores. According to the structural advantages of 3D hierarchical pores such as interconnected honeycombs, PCE-0.3 as supercapacitor electrode had a high specific capacitance of up to 285.89 F g-1 at 1 A. Furthermore, the supercapacitor exhibited high energy and power density of 21.54 Wh kg-1 and 161.13 W kg-1 , respectively, with a low internal resistance of 0.059 Ω. CONCLUSION: The results indicated that 3D porous carbon materials such as interconnected honeycombs derived from the aromatic biomass of torch ginger leaves have significant potential for the development of sustainable energy storage devices. © 2023 Society of Chemical Industry.

Effectiveness of adequate chicken egg white consumption on dyspnea degree and exacerbation incidence in stable COPD patients practicing strength and endurance exercises.

Lack of physical exercise and inadequate nutritional intake in chronic obstructive pulmonary disease (COPD) patients could lead to low muscle mass and function, which causes reduced respiratory function, increased incidence of exacerbations, exercise intolerance, increased visits to health facilities, and low health status. Therefore, physical exercise and good nutritional intake are the main foundations of a comprehensive pulmonary rehabilitation program for COPD patients. The aim of the study was to determine the effect of chicken egg white supplementation on dyspnea degree and the incidence of exacerbations in stable COPD patients who perform physical exercise independently at home. A quasi-experimental study was conducted in 38 stable COPD patients based on the Global Initiative for Chronic Lung Disease (GOLD) 2021 classification criteria. The patients were divided into two groups: the control group who did smartphone application-assisted physical exercises and the intervention group who did the same physical exercises plus chicken egg white supplementation for 12 weeks. Performed physical exercises included both strength and endurance training. The degree of dyspnea was assessed with modified Medical Research Council (mMRC) dyspnea scale and the incidence of exacerbations was assessed by direct interviews at the beginning and at the end of the intervention. A Fisher's exact test was used to assess the association between the intervention with dyspnea degree and exacerbation incidence. In the intervention group, chicken egg white supplementation for 12 weeks lowered the dyspnea degree by 3.16 times than the control (relative risk 3.16 with p=0.001). Furthermore, the incidence of exacerbations was also reduced by 1.8 times compared to the control group (relative risk 1.8, p=0.001). This study highlights a significant improvement in dyspnea degree and exacerbation incidence in COPD patients with the combination of protein supplementation and physical exercise. Therefore, adding chicken egg white intake could be beneficial for stable COPD patients practicing physical exercises.

Antioxidant and antiaging activities of Cinnamomum burmannii, Michelia champaca and their combinations.

Aging is a natural skin process that occurs due to intrinsic and extrinsic factors, such as excessive exposure to ultraviolet light (photoaging). The mechanism of damage involves the production of excess free radicals that trigger oxidative stress in the skin. Determining the natural products that have high antioxidant activities as antiaging is important. Cinnamomum burmannii and Michelia champaca are typical Aceh plants that are believed to have high antioxidant effects. The aim of this study was to determining the contents of C. burmannii and M. champaca as well as to determine the antioxidant and antiaging activities of either individually or combinations. The qualitative phytochemical and semi-quantitative analysis of the extracts were measured using gas chromatography-mass spectroscopy (GC-MS). The antioxidant activity was examined by radical scavenging using the 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical method while the antiaging activity was measured using the tyrosinase enzyme inhibition test. The phenolic and flavonoid contents of C. burmannii were higher than M. champaca (66.34 vs 24.71 mg gallic acid equivalent/gr and 80.52 vs 60.20 mg quercetin equivalent/gr, respectively. The inhibitory concentration (IC50) of M. champaca extract in inhibiting DPPH indicated that M. champaca had a better antioxidant activity than C. burmannii. The combination of C. burmannii and M. champaca extracts had a lower IC50 compared to M. champaca alone. C. burmannii and M. champaca extracts had a weak potential to inhibit tyrosinase activity (IC50 value ≥1000 µg/mL). In conclusion, this study indicates that M. champaca and C. burmannii have strong antioxidant activities and these might associate with polyphenol contents.

Functional capacity and quality of life improvement in stable chronic obstructive pulmonary disease (COPD) patients following physical exercise and chicken egg white supplementation.

The pillars of comprehensive pulmonary rehabilitation program for chronic obstructive pulmonary disease (COPD) patients include physical exercise and good nutrition. The aim of this study was to evaluate the efficacy of pulmonary rehabilitation, which included physical exercise and chicken egg white supplementation, on the quality of life (QoL) and functional capacity among patients with stable COPD. The COPD patients were enrolled prospectively in this quasi-experimental study and completed a 12-week smartphone-guided home-based physical exercise program that comprised strength and resistance training three times per week for 30 minutes each session. Participants were divided into two groups: the control group who underwent physical exercise only, and the intervention group who had physical exercise and chicken egg white supplementation as a protein source. Patient characteristics including sex, age, nutritional status, comorbidities, smoking status, and obstruction severity, were evaluated. The COPD assessment test (CAT) score and six-minute walk test (6MWT) were used as the parameters to evaluate QoL and functional capacity, respectively. Of the total 50 patients included in the study, 12 were excluded due to follow-up and adherence problems. Our data indicated there were significant CAT score reduction and 6MWT improvement in both control and intervention groups after 12 weeks compared to baseline data. However, reduction of mean CAT score was higher in intervention compared to control group (-13.47±6.49 vs -5.42±5.07, p<0.001). In addition, the improvement of 6MWT was also higher in intervention group compared to control group (145.47±69.2 vs 32.42±17.3 meters, p<0.001). In conclusion, chicken egg white supplement to male patients with stable COPD who exercise with resistance and strength training could improve the QoL and functional capacity.

Translation and performance of the Finnish Diabetes Risk Score for detecting undiagnosed diabetes and dysglycaemia in the Indonesian population.

A diabetes risk score cannot directly be translated and applied in different populations, and its performance should be evaluated in the target population. This study aimed to translate the Finnish Diabetes Risk Score (FINDRISC) instrument and compare its performance with the modified version for detecting undiagnosed type 2 diabetes mellitus (T2DM) and dysglycaemia among the Indonesian adult population. Forward and backward translations were performed and followed by cultural adaptation. In total, 1,403 participants were recruited. The FINDRISC-Bahasa Indonesia (FINDRISC-BI) was scored according to the original FINDRISC instrument, while a Modified FINDRISC-BI was analyzed using a specific body mass index and waist circumference classification for Indonesians. The area under the receiver operating characteristic curve, sensitivity, specificity, and the optimal cut-offs of both instruments were estimated. The area under the receiver operating characteristic curve for detecting undiagnosed T2DM was 0.73 (0.67-0.78) for the FINDRISC-BI with an optimal cut-off score of ≥9 (sensitivity = 63.0%; specificity = 67.3%) and 0.72 (0.67-0.78) for the Modified FINDRISC-BI with an optimal cut-off score of ≥11 (sensitivity = 59.8%; specificity = 74.9%). The area under the receiver operating characteristic curve for detecting dysglycaemia was 0.72 (0.69-0.75) for the FINDRISC-BI instrument with an optimal cut-off score of ≥8 (sensitivity = 66.4%; specificity = 67.0%), and 0.72 (0.69-0.75) for the Modified FINDRISC-BI instrument with an optimal cut-off score ≥9 (sensitivity = 63.8%; specificity = 67.6%). The Indonesian version of the FINDRISC instrument has acceptable diagnostic accuracy for screening people with undiagnosed T2DM or dysglycaemia in Indonesia. Modifying the body mass index and waist circumference classifications in the Modified FINDRISC-BI results in a similar diagnostic accuracy; however, the Modified FINDRISC-BI has a higher optimal cut-off point than the FINDRISC-BI. People with an above optimal cut-off score are suggested to take a further blood glucose test.

Adaptation and validation of the HIV Knowledge Questionnaire-18 for the general population of Indonesia.

BACKGROUND: Despite a global decline in new HIV/AIDS cases in low-middle countries, cases are increasing in Indonesia. Low knowledge about the disease among the general population is one of the major factors responsible for this trend. Indonesia does not have a validated instrument to assess HIV/AIDS knowledge. The HIV Knowledge Questionnaire-18 (HIV-KQ-18) has been translated into several languages and is one of the most extensively used instruments for assessing HIV/AIDS knowledge. This paper describes the process of adapting and validating the HIV-KQ-18, an instrument to assess the level of HIV/AIDS knowledge in the general population of Indonesia. METHODS: In the adaptation phase, feedback for the initial Bahasa Indonesia version was gathered from two HIV activists, an obstetrician, two general practitioners, and 60 pilot participants. At the validation stage, we distributed the instrument link via Google Form to 6 major regions in Indonesia. Validity was measured using known-group validity and construct validity. The construct validity was assessed using an exploratory factor analysis (EFA) with a polychoric correlation matrix. Cronbach's alpha was used to analyze the internal consistency. RESULTS: Based on the findings in the adaptation phase, additional descriptions (namely synonyms or examples) were added to 6 items to make them more understandable. In the validation phase, 1,249 participants were recruited. The a priori hypothesis in known-group validity was supported. We also found three items that did not meet the construct validity. Based on the acceleration factor approach to interpret the scree tree in the factor analysis, using only two factors was preferable. Cronbach's alpha values were 0.75 and 0.71 representing good internal reliability. CONCLUSION: The HIV-KQ-18 Bahasa Indonesia is considered a valid and reliable instrument to assess the level of HIV/AIDS knowledge in Indonesia.

Measurement Invariance of the Short Home Attachment Scale: A Cross-Cultural Study.

The home environment is a particularly significant part of life that is supposed to satisfy inhabitants' needs, form their identity, and contribute to psychological wellbeing. The construct of home attachment is especially relevant for students as a most mobile social group. This study is devoted to the validation of the Short Home Attachment Scale (SHAS) in a student sample from five countries (Armenia, India, Indonesia, Russia, and Ukraine). A total of 1,349 (17-26 years; Mage = 19.82, SDage = 2.14; 78% females) university students participated in the study and filled in the 14 items of HAS. In order to avoid redundant items with high error covariances damaging the model, a new scale-the SHAS was developed by eliminating seven items. The shortened scale has satisfactory structure validity in terms of model fit in all countries except Indonesia; internal reliability values were acceptable in all countries. Measurement invariance across countries was tested with Multi-Group Confirmatory Factor Analysis (MG CFA) and Alignment Analysis. MG CFA confirmed both configurational and metric invariance. The invariance of item factor loadings, as well as item intercepts, was also confirmed by the Alignment Analysis. The mean scores varied across cultures, with the highest in India and the lowest in Russia. The final version of SHAS is a valid, reliable tool that may be recommended for use in cross-cultural research. However, the SHAS factor structure robustness in the Indonesian population should be investigated thoroughly.

Comparative performance of ELISA and dot blot assay for TSH-receptor antibody detection in Graves' disease.

BACKGROUND: Graves' disease (GD) is an autoimmune disease, and it accounts for major cases of hyperthyroidism. Antibody against thyroid-stimulating hormone receptor/TSHR (TRAb) is responsible for hyperthyroidism and is considered as a diagnostic marker for GD. Therefore, we developed a recombinant protein of human TSHR-169 (hTSHR-169), which was specifically recognized TRAb in the serum of GD patients and then compare the diagnostic performance between ELISA and dot blot of TRAb tests for their ability to diagnose GD. METHODS: 20 GD patients and 20 healthy individuals from the Indonesian population were enrolled. TRAb concentration and density were quantified. Comparative analysis was performed using receiver-operating curve (ROC) analysis. RESULTS: For dot blot assay, the minimum concentration to detect TRAb requiring 100 ng of antigen with antiserum diluted at 1:60. For diagnosing GD, the ELISA yielded a higher AUC compared with the dot blot assay (0.95 and 0.85, respectively). Using the recommended cutoff values, the efficiency of both assays was examined by comparing the specificity and sensitivity of the assays to the clinical diagnosis. The ELISA showed 80% and 95%, while the dot blot assay showed 70% and 95% sensitivity and specificity, respectively. CONCLUSION: Although the dot blot assay exhibited lower performance than the ELISA method, the dot blot assay is a simple and rapid diagnostic assay that is suitable for diagnosing GD in rural areas, in which healthcare facilities sometimes are not accessible.

Engaging Leadership and Its Implication for Work Engagement and Job Outcomes at the Individual and Team Level: A Multi-Level Longitudinal Study.

The current study investigates how supervisors' engaging leadership, as perceived by their employees, increases employees' job outcomes at the individual and team level, as mediated by (team) work engagement. Job outcome indicators at the team level are team performance, team learning, and team innovation; and at the individual level, job performance, employee learning, and innovative work behavior. The novel concept of engaging leadership is presented as the specific type of leadership to foster (team) work engagement. A multi-level longitudinal study is conducted among 224 blue collar employees nested in 54 teams in an Indonesian state-owned holding company in the agricultural industry using a one-year time lag. The findings show, as expected, that at the team level, engaging leadership at time 1 predicted team learning and team innovation (but not team performance) at time 2, via team work engagement at time 2. Additionally, an expected cross-level effect was observed from engaging leadership at the team level at time 1 predicting individual job performance (but not employee learning and innovative work behavior) at time 2, via team work engagement at time 2. Finally, an expected second cross-level effect was observed for engaging leadership at the team level at time 1, which predicted individual job performance, employee learning, and innovative work behavior at time 2, via work engagement at time 2.