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The Impact of Early Intervention on Motor Outcomes in Infants with Cerebral Palsy: A Longitudinal Study with Advanced Neuroimaging Correlates in Surabaya, Indonesia Habiburrahman Said; Novalika Kurnia; Fatimah Mursyid; Sophia Lucille Rodriguez; Theresia Putri Sinaga; Aline Hafidzah
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.v1i1.29

Abstract

Introduction: Cerebral palsy (CP) is a prevalent neurodevelopmental disorder affecting motor function in children. Early intervention (EI) has been shown to improve motor outcomes in infants with CP, but the underlying neural mechanisms remain poorly understood. This longitudinal study investigated the impact of EI on motor outcomes and its association with neuroimaging correlates in infants with CP in Surabaya, Indonesia. Methods: We recruited 60 infants diagnosed with CP aged 6-18 months in Surabaya, Indonesia. Participants were randomly assigned to either an EI group receiving 6 months of individualized, home-based intervention or a control group receiving standard care. Motor function was assessed using the Gross Motor Function Measure (GMFM-88) at baseline, 6 months, and 12 months. Advanced neuroimaging techniques, including diffusion tensor imaging (DTI) and functional magnetic resonance imaging (fMRI), were used to assess brain structure and function at baseline and 12 months. Results: Infants in the EI group demonstrated significantly greater improvements in GMFM-88 scores compared to the control group at 6 and 12 months (p < 0.05). DTI revealed increased fractional anisotropy (FA) in the corticospinal tract and corpus callosum in the EI group at 12 months, indicating improved white matter integrity. fMRI showed increased functional connectivity in motor networks in the EI group compared to the control group at 12 months. Conclusion: Early intervention significantly improved motor outcomes in infants with CP in Surabaya, Indonesia. These improvements were associated with enhanced white matter integrity and functional connectivity in motor-related brain regions. Our findings highlight the importance of early intervention in promoting neuroplasticity and improving motor function in infants with CP.
Early Detection of Hearing Loss in Neonates in Mexico: Comparing the Accuracy of Auditory Brainstem Response and Otoacoustic Emissions Sophia Lucille Rodriguez; Made Swastika; Theresia Putri Sinaga
Sriwijaya Journal of Otorhinolaryngology Vol. 2 No. 1 (2024): 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.v1i2.80

Abstract

Introduction: Early detection of hearing loss in neonates is critical for timely intervention and optimal speech and language development. This study aimed to compare the accuracy of Auditory Brainstem Response (ABR) and Otoacoustic Emissions (OAEs), two commonly used hearing screening methods, in identifying hearing loss in newborns in Mexico City. Methods: A prospective cross-sectional study was conducted at a tertiary care hospital in Mexico City. Newborns were screened with both ABR and OAEs within the first 48 hours of life. Infants who failed either screening test underwent diagnostic audiological evaluation by three months of age. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ABR and OAEs were calculated using the diagnostic evaluation as the gold standard. Results: A total of 500 newborns were included in the study. The prevalence of hearing loss was 3%. ABR had a sensitivity of 95%, specificity of 92%, PPV of 60%, and NPV of 99%. OAEs had a sensitivity of 85%, specificity of 90%, PPV of 45%, and NPV of 98%. ABR demonstrated significantly higher sensitivity compared to OAEs (p<0.05). Conclusion: ABR exhibited higher sensitivity in detecting hearing loss in neonates compared to OAEs. However, both methods demonstrated high NPV, suggesting their suitability for universal newborn hearing screening programs. The choice between ABR and OAEs may depend on available resources and the specific needs of the healthcare setting.
Social Determinants of Health and Their Influence on Preterm Birth in Rural Indonesian Communities Miranda Aisah; Tomiola Owkwulu; Winata Putri; Theresia Putri Sinaga; Syaifudin Syaifudin; Reza Andrianto
Sriwijaya Journal of Obstetrics and Gynecology Vol. 1 No. 2 (2023): 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.v1i1.22

Abstract

Introduction: Preterm birth (PTB), defined as birth before 37 completed weeks of gestation, is a major contributor to neonatal mortality and morbidity globally, with a disproportionate burden in low-resource settings like rural Indonesia. This study aimed to investigate the influence of social determinants of health (SDOH) on PTB in rural Indonesian communities. Methods: A retrospective cohort study was conducted using data from the Indonesian Maternal and Perinatal Health Survey (IMPHS) 2018-2021. A total of 15,480 women residing in rural areas with singleton pregnancies were included. SDOH variables examined included maternal education, socioeconomic status (SES), access to healthcare, and geographical remoteness. Multivariable logistic regression analysis was performed to assess the association between SDOH and PTB, adjusting for potential confounders. Results: The prevalence of PTB in the study population was 12.3%. Lower maternal education, lower SES, limited access to healthcare, and residing in remote areas were significantly associated with increased odds of PTB. Women with no formal education had 2.1 times higher odds of PTB compared to those with higher education (adjusted odds ratio [aOR] 2.1, 95% CI 1.8-2.5). Similarly, women in the lowest SES quintile had 1.8 times higher odds of PTB compared to the highest quintile (aOR 1.8, 95% CI 1.5-2.2). Conclusion: SDOH significantly influence PTB in rural Indonesian communities. Addressing these social inequities through targeted interventions, such as improving access to education, healthcare, and economic opportunities, is crucial for reducing the burden of PTB and improving maternal and child health outcomes.
Factors Influencing the Success Rates of In Vitro Fertilization (IVF) in Indonesian Couples: A Multicenter Study Sony Sanjaya; Wisnu Wardhana Putra; Theresia Putri Sinaga; Tanvir Ahmed
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.v1i2.85

Abstract

Introduction: In vitro fertilization (IVF) has become an increasingly important assisted reproductive technology for infertile couples in Indonesia. However, success rates remain variable. This multicenter study aimed to identify the factors influencing IVF success rates in Indonesian couples. Methods: A retrospective cohort study was conducted involving 1,245 couples who underwent IVF at three fertility centers in Indonesia between January 2019 and December 2022. Data were collected on demographic characteristics, infertility diagnoses, IVF protocols, and treatment outcomes. The primary outcome was live birth rate per embryo transfer. Multivariable logistic regression analysis was performed to identify independent predictors of IVF success. Results: The overall live birth rate per embryo transfer was 32.7%. Female age was a significant predictor of live birth, with success rates declining steadily after age 35. Other factors associated with higher success rates included the use of intracytoplasmic sperm injection (ICSI), blastocyst transfer, and a higher number of oocytes retrieved. Male factor infertility, endometriosis, and a history of previous failed IVF attempts were associated with lower success rates. Conclusion: This study identified several key factors influencing IVF success rates in Indonesian couples. Female age, ICSI utilization, blastocyst transfer, and oocyte yield were significant predictors of live birth. These findings can help clinicians counsel patients and optimize treatment strategies to improve IVF outcomes.
Impact of Integrated Care Models on Chronic Disease Management Outcomes in Underserved Communities: A Mixed-Methods Study in Surabaya, Indonesia Sarah Istiqomah; Iting Shofwati; Theresia Putri Sinaga; Lin Chia
Community Medicine and Education Journal Vol. 6 No. 1 (2025): Community Medicine and Education Journal
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/cmej.v6i1.695

Abstract

Integrated care models (ICMs) are increasingly promoted as a strategy to improve chronic disease management, but evidence of their effectiveness in resource-constrained settings like Surabaya, Indonesia, is limited. This study aimed to evaluate the impact of an ICM on chronic disease management outcomes in underserved communities in Surabaya. A mixed-methods study design was employed, combining a quantitative quasi-experimental component with qualitative data collection. The quantitative component compared pre- and post-intervention data on key clinical indicators (blood pressure control, HbA1c levels, medication adherence) and healthcare utilization (hospital admissions, emergency room visits) for patients with hypertension, diabetes, and cardiovascular disease enrolled in an ICM program (n= 250) versus a control group receiving standard care (n= 250). Data was analyzed using descriptive statistics, t-tests, and chi-square tests. The qualitative component involved semi-structured interviews with patients (n=30) and healthcare providers (n=15) participating in the ICM to explore their experiences and perceptions of the program's impact. Thematic analysis was used to analyze the qualitative data. The quantitative analysis revealed statistically significant improvements in several clinical indicators for the ICM group compared to the control group. Data showed a mean reduction in systolic blood pressure of 8 mmHg (p<0.001) and a decrease in HbA1c levels of 0.7% (p<0.01) in the ICM group. Hospital admissions related to chronic disease complications were also lower in the ICM group (p<0.05). Qualitative findings highlighted improved patient self-management, enhanced provider coordination, and increased patient satisfaction with the ICM. Barriers to implementation included resource constraints, logistical challenges, and the need for ongoing provider training. In conclusion, this study provides evidence that ICMs can improve chronic disease management outcomes in underserved communities in Surabaya, Indonesia. The findings support the scaling up of ICMs in similar settings, with careful consideration of resource allocation, provider training, and community engagement.
The Epidemiology of Oral Carcinogenesis in the Indonesian Archipelago: A Cross-Sectional, Population-Based Analysis of Oral Cancer and Potentially Malignant Disorders Driven by Kretek Smoking and Betel Quid Chewing Mariana Alifah; Sudarto Sudarto; Khalil Jibran; Theresia Putri Sinaga; Lisye Tiur Simanjuntak; Priscilla Kapoor
Crown: Journal of Dentistry and Health Research Vol. 2 No. 2 (2024): 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.v2i2.240

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Introduction: Indonesia faces a severe but poorly quantified epidemic of oral cancer (OC) and oral potentially malignant disorders (OPMDs), driven by culturally endemic habits of kretek (clove cigarette) smoking and betel quid chewing. The absence of robust, large-scale epidemiological data has critically hampered the development of targeted public health interventions. This study aimed to determine the prevalence of OC and OPMDs and to quantify their association with these specific cultural practices in a large, geographically diverse Indonesian population. Methods: A multi-center, cross-sectional study was conducted across the Indonesian archipelago, enrolling 17,850 adults aged ≥30 years through a stratified, multi-stage cluster sampling design at community primary health centers (Puskesmas). Participants completed a structured questionnaire and underwent a standardized oral examination by calibrated dental professionals. All statistical analyses, including bivariate tests and multivariable logistic regression, were performed using survey-specific methods to account for the complex sampling design (stratification, clustering, and weighting) to produce nationally representative estimates. Results: The overall, nationally-weighted prevalence of the combined OC/OPMD outcome was 5.7% (95% CI: 5.2% - 6.2%). The prevalence was 4.9% for OPMDs and 0.8% for OC. After adjusting for confounders in a survey-weighted multivariable logistic regression model, current kretek smoking (Adjusted Odds Ratio [AOR]: 6.15; 95% CI: 4.98 - 7.59) and current betel quid chewing (AOR: 9.22; 95% CI: 7.31 - 11.63) were the most powerful factors associated with the presence of OC/OPMDs. A significant, non-linear dose-response relationship was observed for both habits. Conclusion: The burden of oral cancer and its precursors in Indonesia is substantial and is overwhelmingly associated with the culturally embedded habits of kretek smoking and betel quid chewing. These findings provide definitive, population-level evidence underscoring the urgent necessity for culturally-tailored public health strategies focused on cessation, regulation, and systematic early detection to mitigate this preventable cancer epidemic.
Psychobiological Mechanisms of Resilience in the Pesantren Ecology: A Comparative Structural Equation Modeling of Distress, Coping, and Salivary Cortisol between Boarding and Non-Boarding Santri in East Java Winata Putri; Irna Nettles; Theresia Putri Sinaga; Vidhya Sathyakirti; Sari Sulistyoningsih
Scientia Psychiatrica Vol. 6 No. 3 (2025): Scientia Psychiatrica
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/scipsy.v6i3.200

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Introduction: The Pesantren (Islamic boarding school) represents a unique educational ecosystem in Indonesia that imposes distinct psychosocial demands on students (Santri). While the academic outcomes of this system are well-documented, the psychobiological divergences between boarding (Mukim) and non-boarding (Kalong) students regarding stress adaptation remain under-researched. Methods: This cross-sectional comparative study involved 500 adolescents (ages 15-18) from four large Pesantrens in East Java, stratified into Boarding (n = 250) and non-boarding (n = 250) groups. Participants completed the Kessler Psychological Distress Scale (K-10), the Connor-Davidson Resilience Scale (CD-RISC-25), and the Brief-COPE. Additionally, morning salivary cortisol samples were collected to assess hypothalamic-pituitary-adrenal (HPA) axis activity. Data were analyzed using MANCOVA and Structural Equation Modeling (SEM). Results: Boarding students exhibited significantly higher baseline psychological distress (p < 0.001) and elevated cortisol levels compared to non-boarders. However, they also demonstrated significantly higher resilience scores and utilization of adaptive religious coping strategies. SEM analysis revealed that while boarding status is a predictor of physiological stress, its impact on psychological distress is fully mediated by adaptive coping mechanisms and community integration. Conclusion: Boarding students face heightened physiological stress loads but possess superior compensatory resilience mechanisms driven by religious coping. Interventions should focus on strengthening these adaptive pathways.