Indonesia's healthcare landscape: embracing innovation in the new health regime.

The comment highlights the intricate health issues in Indonesia, emphasizing urban-rural gaps, healthcare financing challenges, and the government's dedication to Universal Health Coverage (UHC). The country's geographical layout amplifies the struggle of providing healthcare to rural areas, resulting in substantial health concerns like high tuberculosis rates and financial vulnerability for the impoverished. The concern raised underscores the paradox of low state healthcare spending despite high household expenditures, leading to individual payment reliance and underutilization of insurance. The analysis advocates a comprehensive healthcare approach, emphasizing prevention and curative actions. It also stresses the importance of decentralizing decision-making power to local governments for optimizing healthcare funds. The comment concludes by emphasizing the need for innovative solutions in Indonesia's healthcare landscape. It envisions a future where transformative approaches reshape the system, ensuring better health outcomes. Innovation, especially in medical technology, digital health, and healthcare delivery models, is identified as a central theme. The recommendation underscores the importance of creative solutions to address healthcare service limitations and advocates for leveraging advancements in preventive measures, education, and tackling lifestyle issues. The overall aim is to navigate Indonesia through its current healthcare challenges towards a more sustainable and effective system for the benefit of its population.

The physical and psychological effects of occupational noise among seafarers: a systematic review.

The aims were to highlight noise levels on board and the health effects of noise on seafarers. Data was collected from multiple databases: PubMed, Web of Science, Scopus, and Ebsco Host. Initially, the search resulted in a total of 197 articles, 16 were chosen. Several ships were found which most sailors had noise-induced hearing loss (NIHL) (n = 6). The engine room has been defined as having the highest level of noise. In addition, noise exposure was associated with hearing loss, tinnitus, sleep disturbances, communication difficulties, poor concentration, dizziness, depression, anxiety, headache, fatigue, and stress. Noise exposure is not the only factor that causes health problems: the duration of exposure while working, years of career as a maritime worker, age, lifestyle habits (smoking, alcohol consumption), and even hobbies related to loud sound (such as concert/disco attendance, listen to loud music, etc.) were associated with the adverse health effects experienced by seafarers.

The chemoprotective potentials of alpha-lipoic acid against cisplatin-induced ototoxicity: A systematic review.

PURPOSE: Ototoxicity is one of the major adverse effects of cisplatin therapy which restrict its clinical application. Alpha-lipoic acid administration may mitigate cisplatin-induced ototoxicity. In the present study, we reviewed the protective potentials of alpha-lipoic acid against the cisplatin-mediated ototoxic adverse effects. METHODS: Based on the PRISMA guideline, we performed a systematic search for the identification of all relevant studies in various electronic databases up to June 2022. According to the inclusion and exclusion criteria, the obtained articles (n=59) were screened and 13 eligible articles were finally included in the present study. RESULTS: The findings of in-vitro experiments showed that cisplatin treatment significantly reduced the auditory cell viability in comparison with the control group; nevertheless, the alpha-lipoic acid co-administration protected the cells against the reduction of cell viability induced by cisplatin treatment. Moreover, the in-vivo results of the auditory brainstem response (ABR) and distortion product otoacoustic emission (DPOAE) tests revealed a decrease in DPOAE and an increase in ABR threshold of cisplatin-injected animals; however, it was shown that alpha-lipoic acid co-treatment had an opposite pattern on the evaluated parameters. Other findings demonstrated that cisplatin treatment could significantly induce the biochemical and histopathological alterations in inner ear cells/tissue; in contrast, alpha-lipoic acid co-treatment ameliorated the cisplatin-mediated biochemical and histological changes. CONCLUSION: The findings of audiometry, biochemical parameters, and histological evaluation showed that alpha-lipoic acid co-administration alleviates the cisplatin-induced ototoxicity. The protective role of alpha-lipoic acid against the cisplatin-induced ototoxicity can be due to different mechanisms of anti-oxidant, anti-apoptotic, anti-inflammatory activities, and regulation of cell cycle progression.

Anti-apoptotic and anti-fibrotic efficacy of exercise training in hypertensive hearts: A systematic review.

Background: This review aims to summarize the antiapoptotic, pro-survival, and antifibrotic effects of exercise training in hypertensive hearts. Methods: Keyword searches were conducted in PubMed, Web of Science, and Scopus in May 2021. Research published in English on the effects of exercise training on the apoptosis, survival, and fibrosis pathways in hypertension was included. The CAMARADES checklist was used to determine the quality of the studies. Two reviewers independently implemented predesigned protocols for the search and selection of studies, the assessment of study quality, and the evaluation of the strength of evidence. Results: Eleven studies were included after selection. The duration of the exercise training ranged from 5 to 27 weeks. Nine studies showed that exercise training improved cardiac survival rates by increasing IGF-1, IGF-1 receptor, p-PI3K, Bcl-2, HSP 72, and p-Akt. Furthermore, 10 studies showed that exercise training reduced apoptotic pathways by downregulating Bid, t-Bid, Bad, Bak, Bax, TNF, and FADD. Finally, two studies reported the modification and subsequent improvement of physiological characteristics of fibrosis and decreased MAPK p38 and PTEN levels by exercise training in the left ventricle of the heart. Conclusions: The findings of the review showed that exercise training could improve cardiac survival rates and attenuate cardiac apoptotic and fibrotic pathways in hypertension, suggesting that exercise training could act as a therapeutic approach to prevent hypertension-induced cardiac apoptosis and fibrosis. Systematic Review Registration: https://www.crd.york.ac.uk, identifier: CRD42021254118.

The Effect of Physician Communication on Inpatient Satisfaction.

(1) Background: The importance of physician-patient communication and its effect on patient satisfaction has become a hot topic and has been studied from various aspects in recent years. However, there is a lack of systematic reviews to integrate recent research findings into patient satisfaction studies with physician communication. Therefore, this study aims to systematically examine physician communication's effect on patient satisfaction in public hospitals. (2) Methods: Using a keywords search, data was collected from five databases for the papers published until October 2021. Original studies, observational studies, intervention studies, cross-sectional studies, cohort studies, experimental studies, and qualitative studies published in English, peer-reviewed research, and inpatients who communicated with the physician in a hospital met the inclusion criteria. (3) Results: Overall, 11 studies met the inclusion criteria from the 4810 articles found in the database. Physicians and organizations can influence two determinants of inpatient satisfaction in physician communication. Determinants of patient satisfaction that physicians influence consist of amounts of time spent with the patient, verbal and nonverbal indirect interpersonal communication, and understanding the demands of patients. The organization can improve patient satisfaction with physician communication by the organization's availability of interpreter service and physician workload. Physicians' communication with inpatients can affect patient satisfaction with hospital services. (4) Conclusions: To improve patient satisfaction with physician communication, physicians and organizational determinants must be considered.

The Effectiveness of Health Services Delivered by Community Health Workers on Outcomes Related to Non-Communicable Diseases among Elderly People in Rural Areas: A Systematic Review.

BACKGROUND: The number of elderly and the burden of non-communicable diseases increase with time. Community involvement is expected to be an important prevention agent for their neighbors. This study aimed to determine the effectiveness of health services delivered by community health workers (CHWs) which focus on physiological indices related to non-communicable diseases among elderly people and to explain the health services or interventions carried out by CHWs. METHODS: This systematic review was conducted based on the PRISMA guidelines. PubMed, ProQuest Science Database, Scopus, EBSCOhost CINAHL, and Web of Science were taken as the source of databases. Manual search was also conducted for articles published before March 2019 without time restriction. The quality of each study was assessed using Critical Checklist by Joanna Briggs Institute. RESULTS: Of the 3,275 initial studies retrieved, 4 studies were included in qualitative synthesis analysis. Three studies arranged a face-to-face interview, while the other study was conducted over the phone. All the 4 studies were intervention studies. Three of them showed a significant improvement in mean systolic blood pressure for the intervention group compared to the control group. The other study showed a significant improvement in weight loss for the intervention group. CONCLUSION: Health services delivered by CHWs was beneficial to elderly people in rural areas on some physiological indices. It suggested that health services delivered CHWs could contribute toward secondary prevention programs.

The contribution of human error related to occupational accident among traditional divers.

OBJECTIVE: The research aims to identify human error committed by traditional divers while fishing, and to determine the relationship between human error as a cause of occupational accidents at sea. METHOD: A cross-sectional study with total of 186 traditional divers participated. The data was collected by questionnaires, and analyzing with chi-square test (p-value=0.05). RESULTS: More than 83% of respondents had experienced occupational accident and behave human error while diving (81%). Type of human error such as rush of work, never attend safety training and does not have diving certificate, dives more than 30min, continues to work even tired, dives more than once a day, and continues to dive despite bad weather. The types of occupational accidents were slips, scratches, shipwrecks, hit by rocks, and suffered open wounds. The statistical test p value=0.000 (<0.05) and OR=44.883. CONCLUSIONS: There is a relationship between human errors and occupational accident.