Burnout dimension profiles among healthcare workers in Indonesia.

Background: Besides biological impact, COVID-19 also poses a threat to psychological wellbeing and the quality of life. Healthcare workers, especially those assuming a front-line post, are at a higher risk of being affected, both physically and psychologically. This study aims to analyse variables potentially associated with burnout and psychological distress among healthcare workers with various health center stratifications, where we commenced a nationwide survey to establish the baseline data. Method: An analytic observational study with a cross-sectional design was conducted on the 11th - September 18, 2020. Participants were enrolled from healthcare institutions represented by epicenter of the COVID-19 pandemic in Indonesia, which were Java, Sumatra, Bali, and were asked questionnaires, including the Depression, Anxiety and Stress Scale 21 (DASS-21), Maslach Burnout Inventory (MBI), Somatic Symptom Scale 8 (SSS-8), also Well-Being Index (WBI). A linear mixed effect model was used to analyse how three dimensions of burnout vary across occupations. Results: A total of 3629 healthcare workers were analysed in this study. Burnout syndrome was found in 37.5% of healthcare workers. The prevalence of burnout among medical personnel, nurses, and midwives was 44.6%, 33.5%, and 36.2%, respectively. The prevalence of burnout in healthcare workers was most common in Java (38.4%) and healthcare workers who work in the hospital (28.6%). Based on the burnout dimensions, 48.2% of healthcare workers experienced moderate to high emotional exhaustion, 51.8% moderate to high depersonalization, and 96.9% high personal accomplishment. The R 2 values was 0.33,0.28,0.27 for emotional exhaustion, depersonalization and personal accomplishment model. Calculated power of the emotional exhaustion and depersonalization model was 100% for both midwife and nurse variable. Meanwhile, the power of the personal accomplishment model was 100% for midwife and 94.7% for nurse variable. Conclusion: The extent of the three burnout dimensions is pervasive in all occupational levels and the place of work (hospital/community health center).

Genomic profiles of Indonesian colorectal cancer patients.

Background: Colorectal cancer (CRC) is one of the most commonly diagnosed cancers worldwide and genetic mutation plays a vital role in CRC development. A previous study has suggested that genetic alterations among Indonesian patients with CRC might differ from those known in developed countries. This study aimed to describe the genomic profiles of Indonesian patients with CRC. Methods: A total of 13 patients were recruited for this study from May to July 2019. Tissue samples were collected, and genomic DNA was extracted from the samples. AmpliSeq for Illumina Cancer HotSpot Panel v2 Next-generation sequencing was used for DNA sequencing and a genome analysis toolkit was used for local realignment around the discovered variants. Results: A total of 45 genes comprising 391 single nucleotide variants (SNVs) with a depth >10 were observed. The genes with the most variants were STK11, SMAD4, EGFR, and ERBB4 and the genes with the most non-synonymous variants were SMAD4, TP53, FGFR3, CDKN2A, and STK11. Genes and SNVs in at least 90% of all samples consisted of 43 genes comprising 286 variants. Genes with the most non-synonymous SNVs were EGFR, SMO, FGFR3, TP53, STK11, CDKN2A. Genes related to the chromosomal instability pathway, such as TP53, SMAD4, KRAS, and APC, are also found in the analysis. Conclusions: Our findings showed that all patients with CRC in this study had genetic mutations in the chromosomal instability pathway. Analysis of genetic mutation of Indonesian patients with CRC might be crucial for advanced targeted therapy and for better clinical outcomes.

Colorectal cancer patients in a tertiary hospital in Indonesia: Prevalence of the younger population and associated factors.

BACKGROUND: An increasing trend in colorectal cancer (CRC) occurring at younger ages has been observed worldwide, even though incidence is declining in the general population. Most currently available guidelines still recommend CRC screening for older populations, despite an alarming rise in early-onset CRC incidence. Risk stratification is necessary to further determine the population most at risk for early-onset CRC. However, epidemiological data on related clinical characteristics and potential risk factors, especially in developing countries, have not been widely reported. AIM: To investigate the prevalence, demographics, clinicopathologic features, and associated factors of young-onset CRC patients in a tertiary hospital in Indonesia. METHODS: Patients undergoing colonoscopy examination between 2008 and 2019, yielding a diagnosis of CRC were identified from medical records. The subjects were classified into two groups according to their age at diagnosis, namely early-onset (18-49 years old) and late-onset (≥ 50-years-old). Demographic data, characteristics, and risk factors of both onset age groups were evaluated using the chi-square and Fisher's exact test. RESULTS: Among 495 CRC patients confirmed by histopathology, 205 (41.4%) were classified as early-onset and 290 (58.6%) as late-onset. Most subjects in the early-onset CRC group were male (53.7%), with 89.8% displaying adenocarcinoma histopathology. A majority (78%) of the early-onset CRC patients had left-sided tumors, with the rectum (41%) and rectosigmoid (17.6%) being the most common sites. Abdominal pain was the most frequent symptom in the early-onset CRC patients (55.6%), which was significantly higher than that in the late-onset CRC patients (43.8%, P < 0.05). Early-onset CRC cases were more likely to be underweight (34.6% vs 20.0%, P < 0.001) compared to late-onset CRC cases. The proportion of subjects with suspected hereditary nonpolyposis colorectal cancer (HNPCC) was also higher in the early-onset CRC group than in the late-onset age group (9.3% vs 4.1%, P < 0.05). However, no difference was observed in the parental or family histories of CRC cases. CONCLUSION: Early-onset CRC patients were more likely to have abdominal pain, underweight status, and HNPCC suspicion than late-onset CRC patients.