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Early Detection of Bullying Victimization in Indonesian Adults: A Predictive Scoring System Zahra Amir; Husin Sastranagara; Imanuel Simbolon; Neva Dian Permana; Andi Fatihah Syahrir
Scientia Psychiatrica Vol. 6 No. 2 (2025): Scientia Psychiatrica
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/scipsy.v5i4.180

Abstract

Introduction: Bullying victimization among adults is a pervasive problem with significant mental health implications, including depression, anxiety, and even suicidal ideation. Early detection of individuals at risk is crucial for timely intervention and support. This study aimed to develop and validate a predictive scoring system for bullying victimization in Indonesian adults. Methods: A cross-sectional study was conducted with 1,500 Indonesian adults aged 18-55 years. Data were collected using validated questionnaires, including the Indonesian Workplace Bullying Scale, the Kessler Psychological Distress Scale (K10), and the Rosenberg Self-Esteem Scale. Sociodemographic information and history of adverse childhood experiences were also collected. Logistic regression analysis was used to identify predictors of bullying victimization and develop a predictive scoring system. The model's performance was evaluated using receiver operating characteristic (ROC) curve analysis. Results: The prevalence of bullying victimization in the sample was 18.7%. Significant predictors included female gender, younger age, lower socioeconomic status, history of childhood trauma, low self-esteem, and high psychological distress. The predictive scoring system demonstrated good discriminatory ability, with an area under the ROC curve (AUC) of 0.82 (95% CI: 0.79-0.85). Conclusion: This study provides a validated predictive scoring system for identifying Indonesian adults at risk of bullying victimization. This tool can assist mental health professionals, employers, and policymakers in implementing targeted prevention and intervention programs to mitigate the adverse mental health consequences associated with bullying.
Beyond Amyloid: Investigating the Role of Tau Oligomers in Alzheimer's Disease Progression in Medan, Indonesia Sony Sanjaya; Brenda Jaleel; Cindy Susanti; Yi-Fen Huang; Husin Sastranagara; Agnes Mariska
Sriwijaya Journal of Neurology Vol. 1 No. 2 (2023): 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.v1i1.26

Abstract

Introduction: Alzheimer's disease (AD) is a neurodegenerative disorder characterized by cognitive decline and memory impairment. While amyloid plaques have been a central focus of AD research, increasing evidence suggests that tau oligomers play a crucial role in disease progression. This study aimed to investigate the relationship between tau oligomers, cognitive function, and disease severity in AD patients in Medan, Indonesia. Methods: An observasional case series study was conducted involving 50 AD patients diagnosed according to the National Institute on Aging-Alzheimer's Association (NIA-AA) criteria. Cerebrospinal fluid (CSF) samples were collected and analyzed for tau oligomers using an enzyme-linked immunosorbent assay (ELISA). Cognitive function was assessed using the Mini-Mental State Examination (MMSE) and the Clinical Dementia Rating (CDR) scale. Correlation analyses were performed to examine the relationship between tau oligomer levels, cognitive performance, and disease severity. Results: The mean tau oligomer level in AD patients was 120.5 ± 35.2 pg/mL. A significant negative correlation was observed between tau oligomer levels and MMSE scores (r = -0.65, p < 0.001), indicating that higher tau oligomer levels were associated with poorer cognitive performance. Furthermore, tau oligomer levels were positively correlated with CDR scores (r = 0.58, p < 0.001), suggesting a link between tau oligomers and disease severity. Conclusion: This study provides evidence for the involvement of tau oligomers in AD progression in the Indonesian population. Elevated CSF tau oligomer levels are associated with cognitive decline and disease severity in AD patients. These findings highlight the potential of tau oligomers as a therapeutic target and emphasize the need for further research to develop effective interventions.
Optimizing Postoperative Pain Management After Endoscopic Sinus Surgery in Indonesia: A Comparative Study of Analgesic Regimens Nabila Saraswati; Made Swastika; Zahra Amir; Husin Sastranagara; Bernadette Wilson
Sriwijaya Journal of Otorhinolaryngology Vol. 1 No. 2 (2023): Sriwijaya Journal of Otorhinolaryngology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjorl.v1i1.33

Abstract

Introduction: Endoscopic sinus surgery (ESS) is a frequently performed procedure for chronic rhinosinusitis in Indonesia. Effective postoperative pain management is vital for patient comfort, early recovery, and minimizing healthcare expenses. This study compared the efficacy of different analgesic regimens in managing postoperative pain after ESS in an Indonesian population. Methods: This prospective, randomized controlled trial involved 120 patients undergoing ESS at a tertiary hospital in Indonesia. Patients were randomly allocated to one of three groups: Group A received intravenous patient-controlled analgesia (PCA) with morphine, Group B received a combination of intravenous ketorolac and oral paracetamol, and Group C received oral paracetamol alone. Pain intensity was evaluated using the Visual Analog Scale (VAS) at 2, 6, 12, and 24 hours postoperatively. The requirement for rescue analgesia and the occurrence of adverse effects were also documented. Results: Group A (PCA with morphine) exhibited significantly lower VAS scores at all time points compared to Group B (ketorolac and paracetamol) and Group C (paracetamol alone) (p<0.001). Group B showed lower VAS scores than Group C at 2 and 6 hours postoperatively (p<0.05). The need for rescue analgesia was significantly higher in Group C compared to the other groups (p<0.001). The incidence of nausea and vomiting was higher in Group A, while constipation was more frequent in Group B. Conclusion: Intravenous PCA with morphine provided superior postoperative pain control after ESS compared to other analgesic regimens. However, the increased incidence of nausea and vomiting should be taken into account. A combination of intravenous ketorolac and oral paracetamol presented a suitable alternative with a more favorable side effect profile. Further investigation is necessary to optimize pain management protocols for ESS in the Indonesian population.
Prenatal Exposure to Maternal Stress and Neurodevelopmental Outcomes in Children: A Longitudinal Study with Epigenetic Analysis in Jakarta, Indonesia Fatimah Mursyid; Akmal Hasan; Tomiola Owkwulu; Maximillian Wilson; Yi-Fen Huang; Husin Sastranagara
Sriwijaya Journal of Neurology Vol. 2 No. 1 (2024): 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.v1i2.81

Abstract

Introduction: Prenatal exposure to maternal stress has been identified as a potential risk factor for adverse neurodevelopmental outcomes in children. This study aimed to investigate the association between prenatal maternal stress and neurodevelopmental outcomes in children in Jakarta, Indonesia, and to explore the potential mediating role of epigenetic modifications. Methods: A longitudinal cohort study was conducted involving 300 pregnant women recruited from antenatal clinics in Jakarta. Maternal stress was assessed during the second trimester of pregnancy using the Perceived Stress Scale (PSS). Neurodevelopmental outcomes in children were evaluated at 12 and 24 months of age using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). Epigenetic analysis of cord blood DNA methylation was performed using the Illumina Infinium MethylationEPIC BeadChip. Results: Higher maternal stress scores during pregnancy were significantly associated with lower cognitive, language, and motor scores in children at 12 and 24 months of age. Epigenetic analysis revealed differential methylation patterns in genes related to neurodevelopment in children exposed to high prenatal maternal stress. Mediation analysis indicated that DNA methylation partially mediated the association between prenatal maternal stress and neurodevelopmental outcomes. Conclusion: Prenatal exposure to maternal stress is associated with adverse neurodevelopmental outcomes in children, and epigenetic modifications may play a mediating role in this relationship. These findings highlight the importance of addressing maternal stress during pregnancy to promote optimal child neurodevelopment.
Oral Health Status and its Association with Disease Severity in Parkinson's Disease: A Longitudinal Study in Semarang, Indonesia Husin Sastranagara; Syaifudin Syaifudin; Tan Kiew Lee; Nurul Hanifah; Brian Edgar Wicaksana
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.v2i2.171

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Introduction: Parkinson's disease (PD) is a neurodegenerative disorder that affects motor and non-motor functions, including oral health. This longitudinal study aimed to investigate the oral health status of PD patients in Semarang, Indonesia, and its association with disease severity over time. Methods: A cohort of 100 PD patients diagnosed according to the UK Parkinson's Disease Society Brain Bank criteria were recruited from the Neurology Clinic of Private Hospital, Semarang. Oral health assessments, including Decayed, Missing, and Filled Teeth (DMFT) index, periodontal status, and oral hygiene habits, were conducted at baseline and annually for three years. Disease severity was assessed using the Hoehn and Yahr (H&Y) scale and the Unified Parkinson's Disease Rating Scale (UPDRS). Data were analyzed using descriptive statistics, correlation analysis, and regression models. Results: The majority of PD patients exhibited poor oral hygiene and a high prevalence of dental caries and periodontal disease. DMFT scores and periodontal indices worsened significantly over the three-year follow-up period. Disease severity, as measured by H&Y stage and UPDRS scores, was significantly correlated with poorer oral health status. Regression analysis revealed that higher UPDRS scores at baseline predicted a more rapid decline in oral health over time. Conclusion: PD patients in Semarang, Indonesia, experience significant oral health challenges that are associated with disease severity and progression. These findings highlight the need for integrated oral healthcare in the management of PD to improve patients' overall quality of life.
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.
Bridging the Digital Divide: A Mixed-Methods Evaluation of the Efficacy, Accessibility, and Impact of Web-Based Mental Health First Aid Training for Community Health Volunteers (Kader) in Rural Indonesia Zahra Amir; Ni Made Nova Indriyani; Iis Sugandhi; Husin Sastranagara; Muhammad Rusli; Wisnu Wardhana Putra
Indonesian Community Empowerment Journal Vol. 5 No. 2 (2025): Indonesian Community Empowerment Journal
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/icejournal.v5i2.46

Abstract

Significant disparities in mental health service access persist in rural Indonesia, where community health volunteers (known as Kader) represent a vital but undertrained resource. Digital training platforms offer a scalable solution to build mental health literacy, yet their efficacy and accessibility in low-resource, digitally diverse settings remain under-evaluated. This study aimed to evaluate the efficacy, accessibility, and user experience of a novel, web-based Mental Health First Aid (MHFA) training program for Kader in rural Indonesia. We employed a convergent parallel mixed-methods design with a single-group, pre-test/post-test framework. A total of 165 Kader from 15 rural districts across North Sumatra, West Sumatra, and South Sumatra provinces were recruited. Participants completed a 4-week, self-paced, web-based MHFA course. Quantitative data were collected using the Mental Health Knowledge Questionnaire (MHKQ), the Community Attitudes toward the Mentally Ill (CAMI) scale, and the System Usability Scale (SUS) at baseline and post-intervention. Qualitative data were gathered through semi-structured focus group discussions (FGDs) with a purposive subsample of 32 participants to explore user experience and perceived impact. The intervention yielded a highly significant improvement in mental health knowledge, with mean MHKQ scores increasing from 48.5 (SD=10.2) at pre-test to 89.7 (SD=8.8) at post-test (t(164) = -35.1, p < 0.001). Stigmatizing attitudes significantly decreased, as reflected by an increase in mean CAMI scores from 55.3 (SD=12.5) to 81.4 (SD=11.9) (t(164) = -18.9, p < 0.001). The platform's usability was rated favorably, with a mean SUS score of 81.2 (SD=13.4), indicating excellent user-friendliness. Qualitative analysis revealed three primary themes: (1) Digital Empowerment and Overcoming Barriers; (2) Cultural Resonance and Practical Skill Acquisition; and (3) The Emergence of a Supported Community of Practice. In conclusion, web-based MHFA training is an effective, accessible, and well-accepted modality for empowering Kader in rural Indonesia. This digital approach successfully bridges geographical and educational divides, significantly enhancing mental health literacy and reducing stigma. Scaling this model holds immense potential for strengthening community-based mental health services and narrowing the treatment gap in Indonesia and similar low- and middle-income countries.
Modulation of the Cognition-Sleep Nexus in Subjective Cognitive Decline: A 12-Week, Randomized, Double-Blind, Placebo-Controlled Trial of a Standardized Cordyceps militaris Extract Vita Amanda; Daphne Marshall; Zahra Amir; Husin Sastranagara; Danniel Hilman Maulana; Karina Chandra; Fachrudin Sani
Eureka Herba Indonesia Vol. 6 No. 2 (2025): Eureka Herba Indonesia
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ehi.v6i2.130

Abstract

Subjective cognitive decline (SCD) and sleep disturbance form a vicious cycle, accelerating neurodegeneration. Cordyceps militaris (CM), a traditional medicinal fungus rich in nucleosides, possesses potent neuroprotective and adenosinergic (sleep-promoting) properties. We investigated the efficacy of a standardized CM extract on this cognition-sleep nexus in adults with SCD. This 12-week, single-center, randomized, double-blind, placebo-controlled, parallel-group trial was conducted in Palembang, Indonesia. We randomized 120 adults (aged 45-65) with SCD to receive 300 mg/day of a standardized CM mycelial extract (3% cordycepin) or a matching placebo. The primary outcome was the change from baseline in the Montreal Cognitive Assessment-Indonesian (MoCA-INA) score. Key secondary outcomes (Bonferroni-corrected) were the Pittsburgh Sleep Quality Index (PSQI), Rey Auditory Verbal Learning Test (RAVLT) Delayed Recall, and polysomnography (PSG)-derived Sleep Efficiency (SE). Analyses were performed on the Intention-to-Treat (ITT) population (N=120) using a Linear Mixed-Effects Model (LMM). The LMM analysis revealed a significant group-by-time interaction for the primary outcome, MoCA-INA (Adjusted Mean Difference [AMD]: +1.95 [95% CI: 1.10, 2.80], p < 0.001). The CM group also showed significant improvements in all three key secondary outcomes: PSQI (AMD: -2.90 [95% CI: -3.81, -1.99], p < 0.001), RAVLT Delayed Recall (AMD: +2.15 [95% CI: 1.30, 3.00], p < 0.001), and Sleep Efficiency (AMD: +5.8% [95% CI: 3.1, 8.5], p < 0.001). After FDR correction, significant benefits were also seen for processing speed, %REM sleep, and serum BDNF and hs-CRP. The intervention was well-tolerated. In conclusion, twelve weeks of supplementation with a standardized C. militaris extract significantly improved cognitive function, episodic memory, and both subjective and objective sleep in adults with SCD. These benefits were associated with enhanced neuroplasticity and reduced systemic inflammation, supporting its potential as a multi-target, disease-modifying intervention for this at-risk population.