Culturally sensitive patient-centered healthcare: a focus on health behavior modification in low and middle-income nations-insights from Indonesia.

Patient-centered, culturally sensitive healthcare acknowledges the profound impact of cultural beliefs on health behaviors and outcomes, particularly vital in low and middle-income countries (LMICs). Within Indonesia, distinct cultural factors are pivotal in empowering patients, necessitating their integration into healthcare practices. For example, the cultural concept of gotong royong, emphasizing communal collaboration, presents an opportunity to foster community support networks among patients. Moreover, honoring familial ties and involving family members in decision-making enhances patient empowerment. Acknowledging and incorporating spiritual and religious beliefs, which are deeply rooted in Indonesian culture, into healthcare interventions further augments patient empowerment and well-being. In LMICs, including Indonesia, achieving patient empowerment demands implementing critical strategies. Community-based interventions harness local resources and engage the community to drive health behavior change. Culturally sensitive communication bridges the gap between healthcare providers and patients, respecting language nuances and cultural norms. Patient education fosters a comprehensive understanding of health conditions, thereby encouraging active involvement in decision-making. Tailored behavior modification techniques, aligned with cultural beliefs and practices, support the adoption of healthier behaviors among patients. This review emphasizes the pivotal role of patient-centered, culturally sensitive healthcare in LMICs, particularly in Indonesia. It delves into strategies to promote health behavior change within these unique contexts, emphasizing the importance of cultural sensitivity and patient-centered care. The discourse also explores the cultural landscape impacting healthcare, acknowledging the challenges faced in delivering comprehensive healthcare services within these diverse cultural contexts. Additionally, it outlines innovative approaches and success stories in implementing patient-centered care, highlighting how cultural factors intersect with healthcare outcomes. By advocating for integrating culture-specific patient empowerment practices into healthcare methodologies, this article underscores the potential for improved health outcomes, heightened patient engagement, and the delivery of culturally relevant services within LMICs.

Role of the DExH motif of the Japanese encephalitis virus and hepatitis C virus NS3 proteins in the ATPase and RNA helicase activities.

The role of the conserved DExH motif of the Japanese encephalitis virus (JEV) NS3 protein in the ATPase and RNA helicase activities was compared with that of the hepatitis C virus (HCV) NS3 protein. In the DExH motif of JEV NS3, Asp-285 and Glu-286 were essential for both ATPase and RNA helicase activities. Cys-287 was critical for the RNA helicase activity of JEV NS3 but not for ATPase activity. A His-288-to-Ala substitution in the DExH motif of HCV NS3 resulted in an increase in ATPase activity which was suppressed by poly(U). In contrast, alanine substitution at the same site in JEV NS3 did not increase basal ATPase activity which remained to be stimulated by poly(U). Thus, the mutational effect at His in motif II was different in the HCV and JEV NS3 proteins. Mutagenesis at His-288 of JEV NS3 revealed that His was the most preferable amino acid for ATPase activity and Ala, Gly, Asn, Gln, Ser, or Arg could partly substitute for it. However, any other mutation at His-288 completely disrupted the RNA helicase activity of JEV NS3. The results suggest that Cys-287 and His-288 are essential residues especially for the RNA helicase activity of JEV NS3 and the ATPase and helicase activities are separable enzymatic functions.

Identification and characterization of the RNA helicase activity of Japanese encephalitis virus NS3 protein.

The NS3 protein of Japanese encephalitis virus (JEV) contains motifs typical of RNA helicase/NTPase but no RNA helicase activity has been reported for this protein. To identify and characterize the RNA helicase activity of JEV NS3, a truncated form of the protein with a His-tag was expressed in Escherichia coli and purified. The purified JEV NS3 protein showed an RNA helicase activity, which was dependent on divalent cations and ATP. An Asp-285-to-Ala substitution in motif II of the JEV NS3 protein abolished the ATPase and RNA helicase activities. These results indicate that the C-terminal 457 residues are sufficient to exhibit the RNA helicase activity of JEV NS3.

Enterovirus 71 from fatal and nonfatal cases of hand, foot and mouth disease epidemics in Malaysia, Japan and Taiwan in 1997-1998.

Enterovirus 71 (EV71), one of the major causative agents for hand, foot and mouth disease (HFMD), is sometimes associated with severe central nervous system diseases. In 1997, in Malaysia and Japan, and in 1998 in Taiwan, there were HFMD epidemics involving sudden deaths among young children, and EV71 was isolated from the HFMD patients, including the fatal cases. The nucleotide sequences of each EV71 isolate were determined and compared by phylogenetical analysis. EV71 strains from previously reported epidemics belonged to genotype A-1, while those from recent epidemics could be divided into two genotypes, A-2 and B. In Malaysia, genotype A-2 was more prevalent, while in Japan and Taiwan, B genotype was more prevalent. Two isolates from fatal cases in Malaysia and one isolate from a fatal case in Japan were genotype A-2. However, all isolates from three fatal cases in Taiwan belonged to genotype B. The severity of the HFMD did not link directly to certain genotypes of EV71.