The relationship between quality of sleep and physical activity with level of symptom severity post-COVID-19 among HIV/AIDS patients

OBJECTIVE

The COVID-19 pandemic led to many implications for patients after recovering from the disease, including HIV patients. The long symptoms such as breathlessness, fatigue, and sleep deprivation are common complaints for patients post-COVID-19. In this study, we investigate the correlation between sleep quality and physical activity and severity post-COVID-19 among patients at the hospital in Jakarta.

PATIENTS AND METHODS

A cross-sectional study was conducted among 120 post-COVID patients recruited from a public hospital in Jakarta. All participants were aged over 20 years old, diagnosed with HIV/AIDS, and infected by COVID-19 within the last month. Eligibility included primary insomnia for at least 3 months and acute pain and high fever. Outcomes included sleep quality (the Pittsburgh Sleep Quality Index (PSQI), physical activity (the Global Physical Activity Questionnaire (GPAQ), and severity post-COVID-19 (severe post-COVID). Univariate analysis measured demographics, such as age, gender, etc. RESULTS: Among all study participants, 75.8% of patients had poor sleep quality and 60% of respondents 60% moderate physical activity. We found that sleep quality was not significantly associated with severe COVID-19 symptoms (p = 0.409). Physical activity was significantly associated with severe COVID-19 symptoms (p = 0.007). In the multivariate analysis, only physical activity (p = 0.011) and oxygen saturation (p = 0.000) were found to be independently related to the severity of the post-COVID-19 symptoms.

CONCLUSIONS

Physical activity was associated with the severity of the COVID-19 symptoms (p = 0.007). However, sleep quality was not associated with the severity of COVID-19 (p = 0.409). Physical activity may be one of the factors that prevent further severe COVID-19 symptoms. Therefore, physical activity should be considered as an effective factor to reduce the impact of COVID-19 and should be included in health care and prevention strategies.

Resilience in Relation to Adherence to Antiretroviral Therapy in People Living With HIV: A Qualitative Study

Antiretroviral therapy (ART) adherence significantly impacts the survival and quality of life of people living with HIV (PLWH). Despite the challenges faced by PLWH, adherence remains crucial. Thus, cultivating resilience in ART is essential for optimal treatment outcomes. This qualitative study explored the experience of resilience in relation to ART adherence among PLWH. Semi-structured interviews with 10 participants were conducted and inductively analyzed. Participants' resilience in ART adherence was reflected in their achievements related to cultivating the habit of taking medication and in their convictions that the medication was a daily necessity. PLWH developed resilience through strategies encompassing finding purpose through faith and motivation, fostering wellness by obtaining adequate information, enjoying life, managing disease therapy, and adopting a healthy lifestyle, and building connections by finding adequate support and involving in the community. Nurses are crucial in HIV management, fostering resilience for successful ART adherence and ensuring effective treatment outcomes.

Feasibility of Lantern Using WhatsApp to Improve Antiretroviral Therapy Adherence

This pilot study tested the feasibility of Lantern program, an adherence program to HIV medications using WhatsApp, a secure social media messaging application from Meta, for a smartphone-based platform to enhance medication-taking adherence of antiretroviral therapy among people living with HIV in Indonesia. Thirty participants were recruited for this 8-week study. We recruited persons if they had taken antiretroviral therapy for at least 3 months prior to the study, had a smartphone, Internet access, and could use Lantern with WhatsApp. Here, we report the results from the focus group discussions, with the participants evaluating the qualitative aspects of the experiences. The WhatsApp platform was found to be safe, practical, and relatively inexpensive and provided confidentiality for the participants. Three themes emerged from the focus groups: the study motivated participants to take their antiretroviral therapy medications on time, they still set medication reminder alarms, and being in the study made them feel supported. The Lantern program indicated good feasibility and acceptability for adherence to antiretroviral therapies among people living with HIV. Future research should examine on how community organizations and healthcare providers can take advantage of the WhatsApp program to improve adherence to antiretroviral therapies.

Self-awareness as the key to successful adherence to antiretroviral therapy among people living with HIV in Indonesia: A grounded theory study

Background

Adherence to antiretroviral therapy (ART) continues to pose a significant challenge for people living with HIV (PLWH). Non-adherence to ART can have far-reaching implications for patient well-being, particularly in increasing the risk of opportunistic infections when medication is not taken as prescribed.

Objective

This study aimed to develop a theoretical model that explains how PLWH in Indonesia adhere to their ART regimen and the strategies they follow to maintain adherence.

Methods

The study used a grounded theory approach. Data were collected through face-to-face in-depth interviews with 21 PLWH who had been taking ART for six months or more at a non-governmental organization (NGO) in Jakarta, Indonesia, between July 2019 and November 2019. Theoretical sampling was used, and the data analysis method of Corbin and Strauss was utilized, including open coding, axis coding, and selective coding.

Results

Three stages were identified as a process of adherence to the ART regimen: 1) initiating ART, 2) missing the connection, and 3) taking control. Self-awareness was identified as the central core theme describing the ART adherence process.

Conclusion

Having adequate self-awareness to take ART regularly is crucial to improving adherence to ART. Moreover, social support from one's spouse and family members can help patients maintain adherence. Therefore, self-awareness and support systems should be included as components in nursing interventions when starting ART therapy. In addition, nurses can help identify potential support persons and provide information related to ART therapy.

Classifying stigma experience of women living with HIV in Indonesia through the social ecological model

Little is known how stigma theories apply to women living with HIV (WLWH). To apply stigma theories to WLWH, and locate within the dimensions of the Social-Ecological Model (SEM). Using a literature review and a theoretical subtraction to apply stigma forms to the SEM dimensions. WLWH begin to self-stigmatize, receive stigma based on fear from the family and community. Healthcare providers and society stigmatize WLWH by ascribing character flaws to them. The SEM allowed us to locate the dimensions of stigma and identify areas for future interventions for WLWH in Indonesia and other countries.

Interventions in reducing anxiety among patients undergoing percutaneous coronary intervention (PCI): an integrated literature review

<p><strong>Background</strong>: The percutaneous coronary intervention procedure (PCI) is an action to restore reduced coronary artery blood flow due to occlusion or blockage. Complex actions using sophisticated tools with the patient's condition fully aware can cause clients to experience anxiety, both before, during, and after the action. Many patients undergoing PCI experience this symptom of anxiety. These symptoms can lead to activation of the sympathetic nerves, changes in hemodynamic status, to the risk of arrhythmias during or after the procedure. Intervention to reduce anxiety hopefully can stabilize haemodynamic, avoid unwanted effects during and after the procedure, further can also improve the patient's quality of life.</p><p><strong>Purpose</strong>: This integrated literature review aims to find complementary interventions that can be carried out independently to overcome the anxiety experienced among patients undergoing PPCI.</p><p><strong>Methods</strong>: The compiled database was taken from the EBSCO, Scopus, Clinical Key, ProQuest, Science Direct, PubMed, and Cochrane databases, and published in 2015 - 2020 which were then matched with certain specific keywords to get the appropriate articles. A total of 11 selected articles were reviewed and the results were presented in a table. The results of 6 types of intervention were found, almost all of them were significant in reducing anxiety. Next, appraisal of the quality of selected articles is done by using The Critical Appraisal Skills Programme (CASP).</p><p><strong>Results</strong>: There were 11 articles that discussed 6 different forms of intervention in reducing anxiety, including physical therapy (2 articles), relaxation therapy (2 articles), cognitive therapy (2 articles), psychological therapy (1 article), and psychological therapy programs (combined) (1 article) and information / support / counseling (3 articles).</p><strong>Conclusion</strong>: This intervention in addition to reducing anxiety can also reduce stress, hemodynamic balance / physiological indicators, reduce pain, improve quality of life and coping mechanisms.

Knowledge, stigma and health-seeking behavior of patients co-infected with HIV and tuberculosis in Jakarta

The purpose was to identify knowledge and TB stigma, as well as its relationship with health-seeking behavior in HIV and TB co-infection patients. A cross-sectional study was conducted with 115 HIV and TB co-infection patients who visited the VCT Polyclinic in five hospitals in Jakarta. This study was using instruments: Brief HIV-Knowledge Questionnaire (HIV-KQ-18), Knowledge TB survey Questionnaire, Berger HIV stigma Scale, Tuberculosis-Related Stigma Scale. This study showed that respondents had good knowledge of TB (69.6%) and had a low stigma of TB (55.7%), and had a health-seeking behavior that did not delay consultation (55.7%). There was a significant relationship between TB knowledge (p-value: 0.042) and TB stigma (p-value: 0.026) with health-seeking behavior. The results of this study can be used as guidelines to improve education and counseling about TB knowledge and TB stigma in HIV and TB co-infection patients.

Spousal intimacy, type of antiretroviral drug and antiretroviral therapy adherence among HIV patients in Bandung, Indonesia

Background

Antiretroviral Therapy (ART) has been proven effective in reducing the mortality rates among People Living With HIV/AIDS (PLWH). However, poor adherence to ART may result in treatment failure. Few studies examine the relationship between spousal intimacy, type of ART and ART adherence. This study aimed to investigate the association between spousal intimacy, type of ART and antiretroviral therapy adherence among PLWH in Bandung, Indonesia.

Design and Methods

A cross-sectional study was conducted involving 115 adult PLWH who were receiving ART at least for 6 months in RSUD Kota Bandung, they were selected with a consecutive sampling. The data were analyzed using chi-square test.

Results

The majority of PLWH (61.74%) reported had high level of spousal intimacy, about 93.91% PLWH used first line of ART, and 88.69% had high adherence in consuming ART. Spousal intimacy had a significant relationship to antiretroviral adherence (p value < 0.001) and type of ART (p value: 0.031, OR: 7.35) significantly associated with antiretroviral adherence.

Conclusions

PLWH who have high levels of spousal intimacy also have high levels of antiretroviral adherence. PLWH on firstline ART were 7.3 times more adherent on ART.

The experiences of women from <em>Atoin Meto</em> tribe who performed <em>Sifon</em> ritual in the context of HIV/AIDS transmission

Background

Sifon is a sexual intercourse ritual after male circumcision from the Atoin Meto tribe that contributed to HIV/AIDS transmission. Ritual Sifon may put at risk for HIV infection and also the sexual transmisson diseases. Doing ritual Sifon as a culture, without using protection during intercourse becomes one way to get HIV infection from infected men. Few study explore this phenomenon among women who becomes Sifon women. Therefore, the aim of this study is to explore the experience of Sifon women in the context of HIV/AIDS transmission.

Design and Methods

The data was collected from March 2020 to July 2020. This study used a phenomenological approach with a purposive sampling technique. Inclusion criteria: the women from Atoin Meto tribe aged above eighteen years old who have been Sifon women for at least six months. The participants were recruited through traditional healers in Nekbaun village of Kupang District and Timor Tengah Selatan District. The data was analysed by Collaizi method.

Results

Thirteen women were interviewed and we found four themes: lack of knowledge about HIV/AIDS transmission, unaware became Sifon women, women experienced of STDs, using traditional medicine to treat STDs (Timor medicine).

Conclusions

The interpretation of Sifonwomen's experiences that performed Sifon rituals indicated that Sifon is a risk factor for transmitting HIV/AIDS. Preventive and promotional educational programs with cultural approach are needed to reduce the risk of HIV/AIDS transmission.

Factors influencing transmission of tuberculosis in Ngeu Nata culture among Ngada community in Kupang, East Nusa Tenggara, Indonesia: Cross sectional study

Background

Eating “sirih/Betel” (Ngeu Nata) as a culture in Ngada society can become one of the primary source of Tuberculosis (TB) transmission due to share leaves and betel liquid reservoirs together with other people. If one of the people who share leaves is a TB patient, it can transmit TB to other person. The purpose of this study was to identify the factors that influence TB transmission in Ngeu Nata culture using the health belief model approach.

Design and Methods

This study used cross-sectional, involving 110 respondents, selected by consecutive sampling. The respondents were Bajawa ethnicity, age 36-67, at least consume Betel one a day together with other person in Ngada district, East Nusa Tenggara.

Results

The results showed that most respondents had high transmission behavior in betel eating culture (51.8%). Factors related to TB transmission behavior: medical history of TB (p=0.028), knowledge about TB (p=0.038), the perceived of severity of TB (p=0.037); the perceived of benefits (p=0.039) and the perceived of barrier (p=0.038). The dominant factor was knowledge, (OR 2,365 (95% CI) 1,015-5,510).

Conclusions

Implication: nurses should include aspect of Ngeu Nata cultural in designing TB education for Bajawa ethnicity in order to prevent TB transmission in Ngada district, East Nusa Tenggara.

Condom-use negotiation, alcohol consumption, and HIV-risk sexual behavior among female sex workers in Kupang, East Nusa Tenggara, Indonesia: A cross-sectional study

Background

Female Sex Workers (FSW) play a crucial part in HIV transmission. Having unprotective condom during sexual activity can lead to HIV infection. Having lower power in condom negotiation with client can lead FSW not to using condoms during the sexual act. Alcohol consumption was also mediated HIV risk behavior among FSW. This study aimed to evaluate the relationship between condom use-negotiation, alcohol consumption and HIV-risk sexual behavior among female sex workers (FSW) in Kupang.

Design and Methods

A cross-sectional study was conducted with 125 FSWs aged 18 to 60 years recruited from Yayasan Tanpa Batas Kupang with consecutive sampling. The data were analyzed using univariate and the Chi-square test.

Results

The majority of FSWs (61.6%) reported had low negotiation condom use with their clients, about 77.6% reported high levels of alcohol consumption and 64.8% had high-risk sexual behavior. Condom-use negotiation (p-value: 0.003) and alcohol consumption (p-value: 0.037) were found to be significantly associated with HIV-risk sexual behavior.

Conclusions

Future interventions on HIV prevention should focus on empowering young FSWs with condom negotation skills in order to increase condum use. It is also recommended to include information about alcohol consumption and it's relationship wit HIV-risk behavior in order to have better health outcomes for FSW.

The relationship between self-efficacy and spirituality in condom use behaviour among MSM-PLWHA in Bandung, indonesia

Background

The prevalence of HIV/AIDS, especially among Men Who Have Sex With Men (MSM), is increasing. Disease transmission occurs because of the low use of condoms. This study aimed to identify the relationship between condom self-efficacy and spirituality in condom use behavior.

Design and Methods

This study used a cross-sectional design with consecutive sampling techniques. It involved 251 people living with HIV & AIDS (PLWH) MSM. Chi-square test was used in bivariate analysis and then continued with the logistic regression analysis for multivariate analysis.

Results

The results show that there was a significant relationship between condom self-efficacy and condom use behavior with p value <0.05 (OR = 11.298; 95% CI: 4.35-20.1, p value=0.000) and spirituality towards condom use behavior p-value < 0.05 (OR = 3.405; 95% CI : 0.85-3.21, p value : 0.00). In multivariate analysis of multiple logistic regression, condom self-efficacy is the factor that predominantlyinfluences condom use behaviour.

Conclusions

To improve the consistency of condom use, nurses need to prioritize interventions such as counselling activities that focus on increasing self-confidence (self-efficacy).

The Prevalence of Gingival Dendritic Cell Subsets in Periodontal Patients

As the most potent cells activating and polarizing naive T cells, dendritic cells (DCs) are of major importance in the induction of immunity and tolerance. DCs are a heterogeneous population of antigen-presenting cells that are widely distributed in lymphoid and nonlymphoid tissues. Murine studies have highlighted the important role of oral DCs and Langerhans cells (LCs) in orchestrating the physiological homeostasis of the oral mucosa. DCs are also critically involved in pathological conditions such as periodontal diseases, in which gingival DCs appear to have special localization and function. While the characterization of human DCs in health and disease has been extensively investigated in various tissues, this topic was rarely studied in human gingiva. Here, we employed an up-to-date approach to characterize by flow cytometry the gingival DCs of 27 healthy subjects and 21 periodontal patients. Four distinct subsets of mononuclear phagocytes were identified in healthy gingiva: conventional DC type 1 (cDC1), cDC2, plasmacytoid DCs (pDCs), and LCs. In periodontitis patients, the frequencies of gingival LCs and pDCs were dysregulated, as LCs decreased, whereas pDCs increased in the diseased gingiva. This shift in the prevalence of DCs was accompanied by increased expression of the proinflammatory cytokines interleukin (IL)-1β, interferon (IFN)-α, and IFN-γ, while the anti-inflammatory cytokine IL-10 was suppressed. We further found that smoking, a known risk factor of periodontitis, specifically reduces gingival LCs in healthy individuals, indicating a possible role of LCs in the elevated severity of periodontitis in smokers. Collectively, this work reveals the various DC subsets residing in the human gingiva and the impact of periodontitis, as well as smoking, on the prevalence of each subset. Our findings provide a foundation toward understanding the role of human DCs in orchestrating physiological oral immunity and set the stage for the evaluation and modulation of shifts in immunity associated with periodontitis.

EFFECT OF PROGRESSIVE MUSCLE RELAXATION ON SLEEP QUALITY AMONG PATIENTS WITH CHRONIC DISEASES: A LITERATURE REVIEW

Background: Sleep disturbance is prevalent among patients with chronic diseases. Thus, the use of non-pharmacological interventions is needed. Progressive muscle relaxation is considered effective to improve sleep quality, but its discussion is still limited.Objective: To investigate the effect of progressive muscle relaxation on sleep quality among chronic disease patients.Design: Literature review.Data Sources: Search was performed through the CINAHL, Science Direct, and ProQuest database from 2014 to 2019 for English-based, full-text research articles.Review Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methods was used to select articles. Critical Appraisal Skills Programme was used for quality assessment.Results: From the 644 articles yielded, six articles were included. Progressive muscle relaxation could be given alone or in combination with cognitive behavioural therapy. It also has been proven to improve sleep quality among patients with chronic diseases regardless their ages. Procedures in progressive muscle relaxation vary, but all studies reported significant improvements on sleep quality. Most of studies used audio as a medium for progressive muscle relaxation training.Conclusion: Progressive muscle relaxation significantly improves the sleep quality among patients with chronic diseases. It is recommended for future studies to compare the effectivity between 4 or 7 muscle groups and 16 muscle groups on sleep quality.

The Correlation between Stigma and Family Acceptance with Religiosity of PLWH MSM in Medan, Indonesia

There are several factors related to religiosity of PLWH MSM in Medan. This study aimed to identify the correlation between stigma and family acceptance with religiosity of PLWH MSM in Medan. This cross-sectional study applied purposive sampling technique and involved 175 samples from H. Adam Malik Public Central Hospital, Medan Pirngadi Hospital, Padang Bulan and Teladan Public Health Centers. The data was analyzed using the multiple logistic regression technique. Bivariate analysis showed a significant correlation between stigma along with family acceptance with religiosity of PLWH MSM in Medan (p = 0.005; α = 0.005).

Phenomenological study: the experiences of patients with nasopharyngeal cancer after undergoing chemoradiation

Background

Chemoradiation is a combination therapy of chemotherapy and radiotherapy. Because chemotherapy is given together with radiotherapy, the side effects are heavier and more severe for some patients. For nasopharyngeal cancer patients, the side effects involve nausea, vomiting, anorexia, diarrhea, mucositis, xerostomia, and tasting and hearing loss, which influence their quality of life. The purpose of this study was to explore the experiences of patients with head and neck cancer undergoing chemoradiation.

Methods

A Phenomenogical desctipve, involving in depth interviewes was conducted during a 6 month study period. Eleven patiets with nasopharyngeal cancer participated in indepth inteviews Colaizzi’s method was used in analyzing data. The selection of participants in this study using purposive sampling method the inclusion criteria were1) the patient had been diagnosed with head and neck cancer, 2) minimum age of 18 years, and 3 had been received external chemoradiation, minimum 14 times of chmemoradiation. The study was conducted at one out-patientradiotherapy department. at Dharmais Cancer Centre Hospital, Jakarta.

Result

The findings show three main themes: 1) xerostomia was the main physical complaint, 2) patients had decreased social interaction, and 3) having adequate support from the family was important for patients.

Conclusion

The findings suggest involving family members when patients are undergoing chemoradiation. Adequate family support is needed to help the patients adapt to the side effects of chemoradiation with the best possible response.

The relationship between family acceptance and quality of life and self esteem of PLWH MSM in Medan, North Sumatera, Indonesia

OBJECTIVE

To identify the correlation between family acceptance and quality of life and self-esteem of People Living with HIV Men Who Have Sex With Men (PLWH MSM) in Medan.

METHOD

This cross-sectional study applied a purposive sampling technique and involved 175 PLWH MSM from H. Adam Malik Public Central Hospital, Medan Pringadi Hospital, Padang Bulan, and Teladan Public Health Centers. The research instruments used are the Perceived Acceptance Scale (PAS), WHOQOL-BREF, and the Rosenberg Self-Esteem Scale. This research has passed the ethical test of the Faculty of Nursing Universitas Indonesia with number 157/UN2/F12.D/HKP.02.04/2018.

RESULTS

Bivariate analysis found that family acceptance was related to quality of life and self-esteem (p=0.006, α=0.05; p<0.001, α=0.05). Family acceptance has a positive relation with QOL and self-esteem. These results show that high family acceptance is associated with good QOL and high self-esteem.

CONCLUSIONS

Family acceptance is correlated with quality of life and self-esteem. If family acceptance is promoted by especially nursing, quality of life and self-esteem can play an optimum role in decreasing risky sexual behaviors.

The relationship between HIV stigma and adherence to antiretroviral (ARV) drug therapy among women with HIV in Lampung, Indonesia

OBJECTIVE

The aim of our study was to examine the relationship between HIV stigma and adherence to antiretroviral (ARV) therapy among women with HIV.

METHOD

120 women with HIV involved in this cross-sectional study. The participant were outpatients at the Voluntary Counseling and Testing (VCT) Abdul Moeloek Hospital in Lampung, Indonesia.

RESULTS

We examined data from 120 patients. Through chi-squared tests, a statistically significant correlation between HIV stigma and adherence to ARV therapy was revealed (p-value=0.045; OR 2.274) women with low levels of stigma toward HIV demonstrated adherence to ARV treatment that was 2.27 times greater than that of women with high levels of stigma toward HIV.

CONCLUSIONS

One way to increase adherence to ARV therapy in women with HIV is by minimizing its stigma. This can be done by increasing their self-confidence and not differentiating between people living with HIV and others in the provision of health services.

Self-efficacy, depression, and adherence to antiretroviral therapy (ART) among Indonesian women with HIV

OBJECTIVE

This study aimed at investigating the relationship between self-efficacy, depression, and adherence to antiretroviral therapy (ART) in Indonesian women with HIV.

METHOD

This study employed a cross-sectional research design. The participants were 120 women with HIV aged 18-60 years on self-administered ART regimens.

RESULTS

This study shows a significant relationship between self-efficacy and adherence to ART (p-value=0.004; OR 2.330). Women are living with HIV with high self-efficacy adherence to following their ART 2.33 times more often than those with low self-efficacy. It is shown that a significant relationship exists between depression and adherence to ART (p-value=0.001; OR 3.647). Depressed HIV women took ART medication 3.64 times less often than who did not have depression.

CONCLUSION

It is recommended to increase the level adherence rate by improving self-efficacy and reduce depression.

The relationship between stigma, religiosity, and the quality of life of HIV-positive MSM in Medan, Indonesia

OBJECTIVE

This study aims to determine the relationship between stigma, religiosity, and the quality of life of HIV-positive men who have sex with men (MSM) in Medan.

METHODS

This is an analytical observational study with a cross-sectional approach. Data in demographics, stigma, religiosity, and quality of life were obtained directly from the participants. Data were taken from April to May 2018. There were 175 subjects who met the criteria which; (i) HIV-positive MSM; (ii) aged≥18 y.o.; and (iii) able to read and write.

RESULTS

Bivariate analysis found that there is a negative relationship between stigma and quality of life (p-value=0.007), and there is a positive relationship between religiosity and quality of life (p-value=0.000).

CONCLUSION

These findings suggest that stigma is an indicator of poor quality of life, while higher religiosity is associated with better quality of life. An interdisciplinary approach is needed in health care planning and social services, to improve the quality of life of HIV-positive MSM.

Adolescent-parent communication about sexual and reproductive health among junior high school students in five areas with the highest prevalence of HIV in Indonesia: A qualitative study

OBJECTIVE

To explore female adolescents' perceptions of their communication with their mothers on the topics of sexuality and reproductive health.

METHOD

A qualitative methodology was used for this study. Data were obtained via focus-group discussions involving 78 female junior high school students, aged 11-15 years. The data were analyzed using content analysis. This study was conducted in Papua, Bali, Jakarta, Riau, and Pontianak.

RESULT

Several themes: (1) knowledge of sexuality and reproductive health, (2) mothers as primary sources of information about reproductive health, (3) factors facilitating communication between adolescents girls and their mothers with mothers, and (4) problems faced by adolescent girls when discussing SRH.

CONCLUSION

Although mothers and daughters communicate freely about many topics; however, discussions of SRH occur infrequently. Parent-based approaches could be effective strategies, especially in terms of improving communication with daughters.

Gaining a "normal life": HIV-positive Indonesian female injection drug users in drug recovery

The number of female injection drug users in Indonesia is rapidly increasing. This study explores the experiences of women living with HIV in recovery from heroin injection. Using a ground theory approach, 22 women former drug users in Jakarta participated in this study. Six themes emerged: the challenges of quitting, the role of self-motivation, the utility of methadone treatment, the importance of partner and family support, the transformation of "self" and situation, and the rewards of a normal life if successful. These women's accounts point to the personal and cultural challenges that they faced as women, wives, and mothers.

A NURSING REHABILITATION PROGRAM TO IMPROVE THE QUALITY OF LIFE OF PATIENTS WITH MENINGIOMA: A NARRATIVE REVIEW

Meningioma is the most common type of primary brain tumor, which affect several domains of life, such as physiological, psychological, and social life conditions. Although surgery has been performed on meningioma patients in Indonesia, some patients still experience sequelae such as headache, impaired mobilization, disruption of activity, and visual disturbances. This narrative review aims to describe nursing rehabilitation programs in patients with meningioma in Indonesia. As a result, the nursing rehabilitation program is considered as an integral part of multidisciplinary rehabilitation, which can be applied in the nursing rehabilitation center and in the form of telenursing. The roles of nurses include providing evidence-based direct care, psychosocial support, patient / family education, care coordination, and continuing health promotion starting from the period of patient care in the hospital to discharge. In conclusion, the nursing rehabilitation program has the potential to improve the quality of life in meningioma patients, especially in Indonesia.

Macrophage biology in the Anx-A1-/- mouse

Historical data suggested that a soluble protein, since identified as annexin-A1 (Anx-A1) was released from macrophages following glucocorticoid stimulation and could modulate eicosanoid production and other functions of these cells. Here, we review some recent findings using a line of Anx-A1(-/-) mice to explore the impact of Anx-A1 gene deletion on macrophage biology. The absence of Anx-A1 selectively alters phagocytic capacity of rodent resident peritoneal macrophages apparently through changes in surface adhesion molecule expression. Anx-A1 is also apparently important in the tonic down-regulation of other macrophage functions such as COX-2 induction, PGE(2) release and the production of reactive oxygen species.

The annexin-1 knockout mouse: what it tells us about the inflammatory response

The 37kDa protein annexin 1 (Anx-1; lipocortin 1) is a glucocorticoid-regulated protein that has been implicated in the regulation of phagocytosis, cell signalling and proliferation, and postulated to be a mediator of glucocorticoids action in inflammation and in the control of anterior pituitary hormone release. Immuno-neutralisation or antisense strategies support this hypothesis as they can reverse the effect of glucocorticoids in several systems. We recently generated a line of mice lacking the Anx-1 gene noting that some tissues taken from such animals exhibited an increased expression of several proteins including COX-2 and cPLA2. In models of experimental inflammation, Anx-1(-/-) mice exhibit an exaggerated response and a partial or complete resistance to the anti-inflammatory effects of glucocorticoids. Several other anomalies were noted including abnormal leukocyte adhesion molecule expression, an increased spontaneous migratory behaviour of PMN in Anx-1(-/-) mice and a resistance in Anx-1(-/-) macrophages to glucocorticoid inhibition of superoxide generation. This paper reviews these and other data in the light of the development of the 'second messenger' hypothesis of glucocorticoid action.