An Analysis of the Psychosocial, Financial and Emotional Needs of Adolescent and Young Adult Cancer Survivors in Singapore Through Focus Group Discussions

Background: The adolescent and young adult (AYA) population, aged between 15-39 years, is an understudied and medically underserved community of cancer survivors in Singapore. Aim: This study was designed to elicit perspectives on various psychosocial, emotional and financial concerns that the AYA cancer survivors (CS) encountered, in their transition to survivorship. Methods: The AYA CS in the age range of 18-39 years, with at least 6 months to 2 years since diagnosis and/or completion of curative treatment were recruited for this study. Four focus group discussions, which consisted of 2-4 respondents, were conducted within the premises of National Cancer Centre Singapore. Participants were prompted by the facilitator with a series of open-ended questions on themes specific to survivorship, including treatment side-effects, sexual and reproductive health concerns, changes in work or education and survivorship support services. Participants' responses were then transcribed verbatim, and analyzed through qualitative content analysis. Results: Twelve AYA, with a mean (±SD) age of 27.1 (±5.9) years, participated in four focus group discussions. The mean (±SD) number of years since cancer diagnosis was 2.3 (±0.6) years, with majority diagnosed with non-Hodgkin's lymphoma (41.6%) and germ cell tumor (25.0%). AYA CS were greatly affected by physical side-effects such as alopecia, changes in body image, and cognitive changes. There were also emotional concerns including the fear of recurrence, infertility anxieties, poor insurance coverage and lack of career advancement opportunities. Majority expressed that they preferred consulting a specialist rather than a general practitioner for their follow-up care. Conclusion: The AYA CS suffer from a multitude of problems as they transit toward survivorship. Innovative and effective survivorship care models are required to timely address their bio-psychosocial, financial and emotional concerns.

Abdominal rectopexy for the treatment of internal rectal prolapse: a systematic review and meta-analysis

AIM

Internal rectal prolapse (IRP) is a unique functional disorder that presents with a wide spectrum of clinical symptoms, including constipation and/or faecal incontinence (FI). The present review aims to analyse the results of trials evaluating the role of abdominal rectopexy in the treatment of IRP with regard to regarding functional and technical outcomes.

METHOD

A systematic review of the literature for the role of abdominal rectopexy in patients with IRP was conducted. PubMed/Medline, Embase and the Cochrane Central Register of Controlled Trials were searched for published and unpublished studies from January 2000 to December 2015.

RESULTS

We reviewed 14 studies including 1301 patients (1180 women) of a median age of 59 years. The weighted mean rates of improvement of obstructed defaecation (OD) and FI across the studies were 73.9% and 60.2%, respectively. Twelve studies reported clinical recurrence in 84 (6.9%) patients. The weighted mean recurrence rate of IRP among the studies was 5.8% (95% CI: 4.2-7.5). Two hundred and thirty complications were reported with a weighted mean complication rate of 15%. Resection rectopexy had lower recurrence rates than did ventral rectopexy, whereas ventral rectopexy achieved better symptomatic improvement, a shorter operative time and a lower complication rate.

CONCLUSION

Abdominal rectopexy for IRP attained satisfactory results with improvement of OD and, to a lesser extent, FI, a low incidence of recurrence and an acceptable morbidity rate. Although ventral rectopexy was associated with higher recurrence rates, lower complication rates and better improvement of bowel symptoms than resection rectopexy, these findings cannot be confirmed owing to the limitations of this review.

Laparoscopic ventral mesh rectopexy vs Delorme's operation in management of complete rectal prolapse: a prospective randomized study

AIM

Various surgical operations have been devised for the treatment of rectal prolapse, yet no ideal procedure has been described. The present study aims to compare the clinical and functional outcome of laparoscopic ventral mesh rectopexy (LVMR) and Delorme's operation for complete rectal prolapse.

METHOD

Fifty patients with complete rectal prolapse were enrolled in this study. Patients were randomly selected to undergo either LVMR or Delorme's procedure after clinical, manometric and radiological evaluation. Patient characteristics, operative data, postoperative complications, recurrence of rectal prolapse and continence state were evaluated. Patients were followed for a mean duration of 18 months.

RESULTS

Thirty-one (62%) patients were women and 19 (38%) patients were men with a mean age of 39.7 ± 6.9 years. Patients were allocated into two equal groups: LVMR group and Delorme's group. Thirty-three (66%) complained of faecal incontinence preoperatively. Patients were followed for 18 months. There was no major postoperative complication or treatment death. Improvement in continence was reported in 80.9% of patients (83.3% in group 1 vs 71.4% in group 2). Recurrent prolapse was observed in 16% of patients in group 2 and 8% in group 1 (P = 0.66). The operation time was significantly greater in group 1 and the length of stay greater in group 2. There was no difference in the fall of constipation score between the groups.

CONCLUSION

There was no statistically significant difference in the incidence of recurrence of complete rectal prolapse or postoperative improvement of symptoms between the two groups. Hospital stay was longer after Delorme's procedure but the operation time was shorter. Neither procedure proved definite superiority regarding the clinical and functional outcome at 18 months of follow-up.

Motivasi Kerja, Internal Locus Of Control dan Kepuasan Kerja Pada Karyawan Bagian Marketing Dan Supporting di PT X Cabang Surabaya

Research that takes the subject 100 employees at PT. X in Surabaya branch fromand marketing supporting division to find the motivation to work and internal locus ofcontrol and job satisfaction in a correlational study. Data collected through questionnairesand analyzed by multiple regression test. The results show the value of F = 3.449; p =0.0036 (p <0.05), which means that work motivation and internal locus of controlcombination has a significant correlation with employees job satisfaction. It can besaid that the hypothesis that states motivation and internal locus of control on employeesat the marketing and supporting division have a relationship with employee satisfaction,that means it can be accepted. The value of R2 = 0.066 describe motivation and internallocus of control simultaneously have contributed effectively to job satisfaction up to 6.6%and that is a quite low in value. Partial test results of work motivation are t = 2.353; p= 0.021 (p <0.05), which means there is a significant positive correlation between workmotivation and job satisfaction, while the result of internal locus of control are = -0.572;p = 0.568 (p> 0.05), that means there is no correlation between the internal locus ofcontrol and job satisfaction.Keywords : Job satisfaction, work motivation, internal locus of control

JAK-STAT and G-protein-coupled receptor signaling pathways are frequently altered in epitheliotropic intestinal T-cell lymphoma

Epitheliotropic intestinal T-cell lymphoma (EITL, also known as type II enteropathy-associated T-cell lymphoma) is an aggressive intestinal disease with poor prognosis and its molecular alterations have not been comprehensively characterized. We aimed to identify actionable easy-to-screen alterations that would allow better diagnostics and/or treatment of this deadly disease. By performing whole-exome sequencing of four EITL tumor-normal pairs, followed by amplicon deep sequencing of 42 tumor samples, frequent alterations of the JAK-STAT and G-protein-coupled receptor (GPCR) signaling pathways were discovered in a large portion of samples. Specifically, STAT5B was mutated in a remarkable 63% of cases, JAK3 in 35% and GNAI2 in 24%, with the majority occurring at known activating hotspots in key functional domains. Moreover, STAT5B locus carried copy-neutral loss of heterozygosity resulting in the duplication of the mutant copy, suggesting the importance of mutant STAT5B dosage for the development of EITL. Dysregulation of the JAK-STAT and GPCR pathways was also supported by gene expression profiling and further verified in patient tumor samples. In vitro overexpression of GNAI2 mutants led to the upregulation of pERK1/2, a member of MEK-ERK pathway. Notably, inhibitors of both JAK-STAT and MEK-ERK pathways effectively reduced viability of patient-derived primary EITL cells, indicating potential therapeutic strategies for this neoplasm with no effective treatment currently available.

Hubungan Antara Religiusitas dan Dukungan Sosial dengan Kebahagiaan Pelaku Konversi Agama

The purpose of this study was to investigate the relationship between religiosity and social support with happiness among perpetrators of religious conversion. The data was collected from 60 participants who had experienced with religious conversion (muallaf) in Chinese Community. The participants were between 40 and 55 years of age. Data of this study was analysed by using a multiple regression analysisThe results of multiple regression analysis showed F = 20,060 with p = 0, 00 (p < 0, 01), it was revealed that religiosity and social support were found to be highly significant with happiness. Therefore, the result of this study indicated that hypothesis that there is any relationship between religiosity and social support with happiness was accepted. The results of partial correlation analysis were; (1) there was positive correlation between religiosity and happiness (r partial = 0,473, t = 4,056, with p = 0,000 (p<0,01)). It means,by increasing the religiosity, the happiness among perpetrators of religious conversion also will increase and (2) there was no any correlation between social support and happiness among perpetrators of religious conversion(r partial = 0,221 t = 1,715,with p = . 0,092 (p>0, 05)).

Pengaruh Experiential Learning Terhadap Kepercayaan Diri Dan Kerjasama Tim Remaja

Intisari. Penelitian ini akan mengkaji pengaruh Experiential learning terhadap kepercayaan diri dan kerjasama tim remaja. Penelitian ini merupakan penelitian eksperimen yang dilakukan pada siswa VII MTs. Babussalam Kalibening Mojoagung Jombang dengan jumlah subyek 60 orang siswa. Pengumpulan data untuk mengungkap kepercayaan diri menggunakan skala kepercayaan diri dan kerjasama tim ukur dengan skala kerjasama tim, sedangkan Experiential learning diberikan sebagai treatmen pada kelompok eksperimen. Analisis data untuk variabel kepercayaan diri dilakukan dengan analisis Mann-Whitney karena data variabel ini tidak homogen dan analisis untuk variabel kerjasama tim dilakukan dengan uji-t student. Hasil penelitian menunjukkan ada perbedaan kepercayaan diri antara kelompok eksperimen yang mendapat treatment Experiential learning dengan kelompok kontrol yang tidak mendapat treatment pretest-post test  (z = -2,537 ; p =0,011). Pada kerjasama tim ada perbedaan kerjasama tim antara kelompok eksperimen yang mendapat treatment Experiential learning dengan kelompok kontrol yang tidak mendapat treatment pretest-post test (t = 3,009 ; p. = 0,002). Hasil tersebut menunjukkan bahwa Experiential learning berpengaruh terhadap kepercayaan diri dan kerjasama tim  remaja.Kata kunci: Experiential learning, Kerpercayaan diri, dan Kerjsama Tim

Enteropathogenic Escherichia coli (EPEC): Does it have a role in colorectal tumourigenesis? A Prospective Cohort Study

BACKGROUND

Despite the characterization of many aetiologic genetic changes. The specific causative factors in the development of sporadic colorectal cancer remain unclear. This study was performed to detect the possible role of Enteropathogenic Escherichia coli (EPEC) in developing colorectal carcinoma.

PATIENTS AND METHOD

Fresh biopsy specimens have been obtained from the colonic mucosa overlying the colorectal cancer as well as from the colon of the healthy controls. Culture, genotyping and virulence of EPEC were done using (nutrient broth culture, and PCR). Strains biochemically identified as Escherichia coli were selected from the surface of a MacConkey's plate and were serogrouped by slide agglutination tests.

RESULTS

From January 2011 to June 2014, 213 colorectal cancer patients (Group 1) and 248 healthy controls (Group 2) were prospectively enrolled in this study. EPEC was positive in 108 (50.7%) in group 1 and 51 (20.6%) in group 2 (P = 0.0001). A significant difference between both groups was observed regarding serotyping, genotyping (eae gene) and virulence category (P = 0.0001). A significant difference between the 2 subgroups of colorectal cancer cases was observed regarding genotyping (eae, bfb genes) and virulence category.

CONCLUSION

The incidence EPEC was higher significantly in patients with colorectal cancer. E. coli in patients with colorectal cancer significantly differed serotypically and genotypically from the E. coli in normal population. E. coli colonization of the colonic mucosa may be a cause colorectal cancer.

Motivasi Intrinsik, Pola Asuh Orangtua Demokratis dan Kreativitas Anak Sekolah Dasar

Abstrak. This study aims to determine the relationship between intrinsic motivation and democratic parenting parents to elementary school children's creativity. Subject of this study is Fifth grade students of Petra 5 Christian Elementary School to 90 students. The results showedthatthere wasa significant correlation between intrinsic motivation and democratic parenting parents to creativity (F = 4.081top=0.023); partially obtained results indicate that intrinsic motivation correlated significant positive towards creativity(t =2.334top=0.024), while between democratic parental parenting variables and creativity did not show anycorrelation(t =0.774top=0.443).Keywords: intrinsic motivation, democratic parenting parents, and creativity.