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Beyond the Binary: Exploring the Lived Experiences of Gender Dysphoric Adolescents in Indonesia Andi Fatihah Syahrir; Ni Made Nova Indriyani; Rheina Weisch Fedre; Shina Abdulkadir
Scientia Psychiatrica Vol. 5 No. 4 (2024): Scientia Psychiatrica
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/scipsy.v5i4.178

Abstract

Introduction: Gender dysphoria among adolescents is increasingly recognized globally, yet research on the lived experiences of transgender youth in Indonesia remains limited. This study aimed to explore the unique challenges, coping mechanisms, and support needs of Indonesian adolescents navigating gender dysphoria within a sociocultural context characterized by traditional gender norms and limited access to specialized healthcare. Methods: In-depth, semi-structured interviews were conducted with 15 adolescents (aged 13-19) who identified as experiencing gender dysphoria. Participants were recruited through LGBTQ+ youth organizations and community centers in Jakarta and Surabaya. Data were analyzed using thematic analysis to identify key themes and patterns within their narratives. Results: Four major themes emerged: (1) Early Recognition and Internal Conflict: Participants described an early awareness of their gender identity incongruence, often accompanied by feelings of confusion, shame, and fear due to societal expectations and potential rejection. (2) Navigating Disclosure and Social Support: Coming out to family and peers was a significant challenge, with varied responses ranging from acceptance to rejection. Support networks, primarily found within online communities and LGBTQ+ organizations, played a crucial role in fostering resilience. (3) Barriers to Accessing Healthcare: Participants reported significant obstacles in accessing gender-affirming care, including limited availability of specialized healthcare providers, financial constraints, and lack of family support. (4) Resilience and Hope for the Future: Despite the challenges, participants expressed resilience, hope, and a strong desire to live authentically. They emphasized the importance of self-acceptance, peer support, and advocacy for greater understanding and acceptance of gender diversity in Indonesia. Conclusion: This study provides valuable insights into the experiences of gender dysphoric adolescents in Indonesia. Findings highlight the urgent need for increased awareness, improved access to gender-affirming care, and supportive interventions to promote the well-being of this vulnerable population.
The Prevalence and Risk Factors for Polycystic Ovary Syndrome (PCOS) among Adolescents in Indonesia: Implications for Early Intervention Habiburrahman Said; Rheina Weisch Fedre; Saurie Hernandez; Sophia Lucille Rodriguez; Fatimah Mursyid; Irna Nettles
Sriwijaya Journal of Obstetrics and Gynecology Vol. 2 No. 1 (2024): Sriwijaya Journal of Obstetrics and Gynecology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjog.v1i2.83

Abstract

Introduction: Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting adolescents, with potential long-term health implications. This study aimed to determine the prevalence and identify risk factors associated with PCOS among Indonesian adolescents. Methods: A cross-sectional study was conducted involving adolescent girls aged 15-19 years from selected schools in Jakarta, Indonesia. Data were collected through questionnaires, physical examinations, and biochemical assessments. PCOS diagnosis was based on the Rotterdam criteria. Logistic regression analysis was used to identify risk factors associated with PCOS. Results: The prevalence of PCOS among Indonesian adolescents was found to be 6.5%. Significant risk factors associated with PCOS included obesity (OR=3.2, 95% CI 2.1-4.8), family history of PCOS (OR=2.5, 95% CI 1.6-3.9), irregular menstrual cycles (OR=4.1, 95% CI 2.8-6.0), and hirsutism (OR=2.8, 95% CI 1.9-4.2). Conclusion: PCOS is prevalent among Indonesian adolescents. Early identification of risk factors such as obesity, family history, irregular menstruation, and hirsutism is crucial for early intervention and management to mitigate potential long-term health consequences.
The Impact of Dental Anxiety on Oral Health-Related Quality of Life in Children: A Longitudinal Study in Jakarta, Indonesia Ni Made Nova Indriyani; Dea Albertina; Desiree Montesinos; Rheina Weisch Fedre; Winata Putri
Crown: Journal of Dentistry and Health Research Vol. 1 No. 2 (2023): Crown: Journal of Dentistry and Health Research
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/crown.v1i2.88

Abstract

Introduction: Dental anxiety is a common problem among children, and it can have a significant impact on their oral health-related quality of life (OHRQoL). This longitudinal study aimed to investigate the impact of dental anxiety on OHRQoL in children in Jakarta, Indonesia. Methods: A cohort of 200 children aged 6-12 years was recruited from six elementary schools in Jakarta. Dental anxiety was assessed using the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) at baseline, 6 months, and 12 months. OHRQoL was measured using the Child Perceptions Questionnaire (CPQ11-14) at the same time points. Sociodemographic data and oral health status were also collected. Linear mixed models were used to assess the association between dental anxiety and OHRQoL over time, adjusting for potential confounders. Results: Dental anxiety was significantly associated with lower OHRQoL scores at all time points. Children with higher dental anxiety scores reported more problems with oral symptoms, functional limitations, emotional well-being, and social well-being. This association persisted even after adjusting for age, gender, socioeconomic status, and oral health status. Conclusion: Dental anxiety has a significant negative impact on OHRQoL in children. Early identification and management of dental anxiety are crucial to improve children's oral health and overall well-being.
Development and Validation of the Jakarta Post-Infectious Neurological Complication Risk Score (JPINCoRS) for Children Fatimah Mursyid; Husin Sastranagara; Rheina Weisch Fedre; Daphne Marshall
Sriwijaya Journal of Neurology Vol. 3 No. 1 (2025): Sriwijaya Journal of Neurology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjn.v2i2.181

Abstract

Introduction: Post-infectious neurological complications (PINCs) in children represent a significant burden, particularly in developing countries like Indonesia. The early identification of high-risk children is crucial for timely intervention and resource allocation. We aimed to develop and validate a clinically applicable risk stratification score for PINCs in a Jakarta-based pediatric population. Methods: A prospective cohort study was conducted at three major tertiary hospitals in Jakarta, Indonesia, between January 2020 and December 2022. Children aged 1 month to 18 years admitted with a primary infectious diagnosis were eligible. Potential risk factors were collected through detailed medical history, physical examination, and laboratory investigations. The primary outcome was the development of a PINC, defined as any new neurological deficit persisting for at least 24 hours after the acute infectious phase, and categorized using a modified Rankin Scale (mRS). Multivariable logistic regression was used to identify independent predictors and develop the Jakarta Post-Infectious Neurological Complication Risk Score (JPINCoRS). Results: A total of 1250 children were enrolled, with 188 (15.0%) developing a PINC. The final JPINCoRS model included six independent predictors: (1) Type of infection (Central Nervous System [CNS] infection: odds ratio [OR] 4.5, 95% CI 3.2-6.3; Systemic infection with sepsis: OR 2.8, 95% CI 1.9-4.1), (2) Duration of fever >5 days (OR 2.2, 95% CI 1.5-3.2), (3) Presence of seizures during the acute infection (OR 3.5, 95% CI 2.4-5.1), (4) Altered mental status (Glasgow Coma Scale [GCS] <13) at admission (OR 3.0, 95% CI 2.1-4.3), (5) Thrombocytopenia (platelet count <100 x 10^9/L) (OR 1.9, 95% CI 1.3-2.8), and (6) Elevated C-reactive protein (CRP) >50 mg/L (OR 2.1, 95% CI 1.4-3.0). The JPINCoRS demonstrated good discrimination (area under the receiver operating characteristic curve [AUC] = 0.85, 95% CI 0.82-0.88) and calibration. Risk categories were defined as low (0-3 points), moderate (4-7 points), and high (8-12 points), with corresponding PINC rates of 3.5%, 18.2%, and 48.6%, respectively. Internal validation confirmed the model's robustness. Conclusion: The JPINCoRS is a simple, clinically applicable tool for predicting PINCs in children in Jakarta, Indonesia. It can aid clinicians in identifying high-risk patients who may benefit from closer monitoring, neuroimaging, and early intervention strategies. Further external validation in other settings is warranted.
Metatranscriptomic Profiling of the Subgingival Microbiome in Peri-implantitis versus Healthy Implants: Identifying Key Dysbiotic Pathways Rheina Weisch Fedre; Ramakhrisnand Ramakhrisnand; Firman Hadi; Mahmood Abbas
Crown: Journal of Dentistry and Health Research Vol. 3 No. 1 (2025): Crown: Journal of Dentistry and Health Research
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/crown.v3i1.237

Abstract

Introduction: Peri-implantitis is a primary cause of dental implant failure, characterized by inflammatory destruction of supporting tissues. While microbial dysbiosis is implicated, the functional activities of the subgingival microbiome that drive disease pathogenesis remain poorly understood. This study aimed to elucidate the key functional and metabolic shifts in the subgingival microbiome associated with peri-implantitis using metatranscriptomic analysis. Methods: This cross-sectional study involved twenty patients, ten with healthy implants (HI) and ten diagnosed with peri-implantitis (PI). Subgingival biofilm samples were collected from the deepest peri-implant sulcus of each subject. Total RNA was extracted, followed by library preparation and sequencing on an Illumina NovaSeq platform. Bioinformatic analysis included quality control, taxonomic profiling using Kraken2, and functional annotation against the KEGG and Gene Ontology databases. Differential gene expression analysis was performed using DESeq2 to identify microbial transcriptional signatures distinguishing the PI and HI groups. Results: The metatranscriptome of the PI group exhibited significantly higher microbial diversity and a distinct taxonomic composition, with a notable enrichment of transcripts from species such as Porphyrononas gingivalis, Tannerella forsythia, and Fusobacterium nucleatum. In contrast, the HI group was dominated by transcripts from commensal streptococci. Functional analysis revealed a significant upregulation of pathways related to bacterial virulence, including lipopolysaccharide (LPS) biosynthesis, bacterial secretion systems (Type IV), and iron acquisition in the PI group. Furthermore, pathways associated with amino acid metabolism, particularly arginine and tryptophan degradation, were highly active, suggesting a proteolytic environment. Conversely, the HI metatranscriptome showed enrichment in carbohydrate metabolism and fermentation pathways. Conclusions: The subgingival microbiome in peri-implantitis is not only taxonomically distinct but also functionally primed for pathogenicity. The active transcription of genes related to virulence, inflammation induction, and proteolytic metabolism highlights the key dysbiotic pathways that likely contribute to tissue destruction. These findings provide a deeper understanding of the functional gene expression profile in peri-implantitis and suggest potential targets for future diagnostic and therapeutic strategies aimed at modulating microbial activity rather than merely eliminating specific taxa.