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All Journal Scientia Psychiatrica Sriwijaya Journal of Obstetrics and Gynecology Sriwijaya Journal of Neurology Sriwijaya Journal of Otorhinolaryngology
Aline Hafidzah
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Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health

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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.
First Trimester Ultrasound Biomarkers for Predicting Preeclampsia: A Prospective Cohort Study in Surabaya, Indonesia Reisha Notonegoro; Aline Hafidzah; Reza Andrianto; Tanvir Ahmed
Sriwijaya Journal of Obstetrics and Gynecology Vol. 3 No. 1 (2025): 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.v2i2.180

Abstract

Introduction: Preeclampsia (PE) remains a leading cause of maternal and perinatal morbidity and mortality worldwide, particularly in developing countries like Indonesia. Early identification of high-risk women is crucial for timely intervention. This study aimed to evaluate the predictive performance of first-trimester ultrasound biomarkers, specifically uterine artery pulsatility index (UtA-PI) and mean arterial pressure (MAP), combined with maternal characteristics, for predicting PE in a cohort of pregnant women in Surabaya, Indonesia. Methods: This prospective cohort study enrolled pregnant women attending their first-trimester antenatal care visit at Private Hospital, Surabaya, between January 2022 and December 2023. Inclusion criteria were singleton pregnancies, gestational age between 11 and 13 weeks 6 days, and availability of complete follow-up data until delivery. Maternal characteristics (age, body mass index, parity, smoking history, family history of PE) were recorded. UtA-PI was measured using transabdominal Doppler ultrasound, and MAP was calculated from blood pressure measurements. The primary outcome was the development of PE, defined according to the International Society for the Study of Hypertension in Pregnancy (ISSHP) criteria. Logistic regression analysis was used to develop a prediction model, and its performance was assessed using receiver operating characteristic (ROC) curves and area under the curve (AUC). Results: A total of 850 pregnant women were included in the final analysis. The incidence of PE was 8.2% (n=70). The prediction model incorporating maternal age, BMI, prior history of PE, UtA-PI, and MAP demonstrated good predictive performance for overall PE (AUC = 0.85; 95% CI, 0.81-0.89). For early-onset PE (delivery <34 weeks), the AUC was 0.92 (95% CI, 0.87-0.97), and for late-onset PE (delivery ≥34 weeks), the AUC was 0.78 (95% CI, 0.73-0.83). UtA-PI and MAP were significant independent predictors of PE (p<0.001). A risk score was developed, with a cut-off value showing a sensitivity of 80% and specificity of 75% for overall PE. Conclusion: The combination of maternal characteristics, UtA-PI, and MAP in the first trimester provides a valuable tool for predicting PE in an Indonesian population. This model demonstrates particularly strong performance for predicting early-onset PE, which is associated with greater maternal and fetal morbidity. Early identification of high-risk women allows for targeted surveillance and potential preventative strategies.
The Indonesian Otitis Media Severity Score (IOMSS): A Prospective Cohort Study Evaluating its Prognostic Value in Pediatric Patients Winata Putri; Aline Hafidzah; Lisye Tiur Simanjuntak; Badrool Nizham; Istiqomah Putri
Sriwijaya Journal of Otorhinolaryngology Vol. 3 No. 1 (2025): 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.v2i2.187

Abstract

Introduction: Acute otitis media (AOM) and otitis media with effusion (OME) are common pediatric illnesses with varying clinical courses. A reliable prognostic tool to predict outcomes and guide treatment decisions in the Indonesian context is lacking. This study aimed to evaluate the prognostic value of the Indonesian Otitis Media Severity Score (IOMSS) in predicting treatment response and complications in pediatric patients with AOM and OME. Methods: A prospective cohort study was conducted at five tertiary care hospitals in Indonesia (Medan, Jakarta, Samarinda, Makassar, and Denpasar) from January 2020 to December 2022. Children aged 6 months to 12 years diagnosed with AOM or OME were enrolled. The IOMSS, which incorporates clinical findings (otalgia, fever, otorrhea, tympanic membrane appearance, and hearing loss), was calculated at baseline. Patients were followed up for 6 months to assess treatment response (resolution of symptoms, tympanic membrane healing), and the development of complications (e.g., recurrent AOM, chronic suppurative otitis media (CSOM), mastoiditis, hearing loss). Statistical analyses, including Cox proportional hazards regression and receiver operating characteristic (ROC) curve analysis, were performed to evaluate the association between IOMSS and clinical outcomes. Results: A total of 850 children (mean age 5.2 ± 2.8 years, 55% male) were included. Higher IOMSS scores at baseline were significantly associated with a lower probability of complete resolution of AOM/OME at 6 months (hazard ratio [HR] 0.85 per 1-point increase in IOMSS, 95% CI 0.80-0.90, p<0.001). The IOMSS also predicted the development of complications, with a higher score significantly increasing the risk of recurrent AOM (HR 1.20, 95% CI 1.10-1.31, p<0.001), CSOM (HR 1.35, 95% CI 1.18-1.54, p<0.001), and persistent hearing loss (HR 1.28, 95% CI 1.12-1.46, p<0.001). ROC curve analysis demonstrated good discriminatory ability of the IOMSS for predicting complications (AUC = 0.82, 95% CI 0.78-0.86). Conclusion: The IOMSS is a valuable prognostic tool for predicting treatment outcomes and the risk of complications in Indonesian children with AOM and OME. Its use can aid clinicians in identifying high-risk patients who may benefit from more aggressive management and closer follow-up.
Loneliness as a Lethal Risk Factor: A Five-Year Prospective Survival Analysis of All-Cause Mortality Among Elderly Residents in Indonesian Vertical Public Housing Dedi Sucipto; Brenda Jaleel; Aline Hafidzah; Oliva Azalia Putri
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.v6i3.199

Abstract

Introduction: Rapid urbanization in Indonesia has necessitated a shift from horizontal settlements (kampung) to vertical public housing (Rusunawa). While providing shelter, these environments may exacerbate "crowded isolation”. This study investigates the synergistic impact of loneliness, depression, and vertical living constraints on all-cause mortality among the elderly. Methods: We conducted a multi-center, prospective cohort study (2018–2023) involving 1,450 elderly residents (> 60 years) in Jakarta and Surabaya. Loneliness was assessed annually using the UCLA Loneliness Scale, and depression via the GDS-15. The primary environmental exposure was "vertical constraint," defined as living above the 3rd floor (Floors 4–12). We utilized Kaplan-Meier survival curves and Multivariable Cox Proportional Hazards models with time-dependent covariates to estimate Hazard Ratios (HR), adjusting for sociodemographic factors and a composite Socioeconomic Status (SES) index. Results: Of 1,398 baseline participants, 218 deaths occurred over 6,890 person-years (15.6% mortality). Severe loneliness was an independent predictor of mortality (Adjusted HR: 1.89; 95% CI: 1.42–2.51). A significant interaction was observed between loneliness and vertical constraint (p=0.003). While residents on higher floors had lower baseline mortality due to selection bias (the "healthy resident effect"), loneliness in this subgroup amplified mortality risk substantially (Interaction HR: 1.76; 95% CI: 1.21–2.55), effectively negating their physical survival advantage. Conclusion: Loneliness is a potent predictor of mortality in Indonesian vertical slums, with lethality accelerated by the physical entrapment of high-floor living. Structural interventions are urgently required to mitigate this "vertical isolation."
Buffering Effects of Extended Family: A Moderated Mediation Analysis of Maternal Depression, Parenting Stress, and Early Childhood Development in West Java, Indonesia Habiburrahman Said; Novalika Kurnia; Aline Hafidzah; Vania Delma; Fachrudin Sani
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.v6i2.201

Abstract

Introduction: In low- and middle-income countries (LMICs), maternal mental health significantly impacts early childhood development (ECD). West Java, Indonesia, presents a unique cultural context where extended family involvement is ubiquitous. This study aims to elucidate the mechanism linking maternal depressive symptoms to early childhood developmental delays, focusing on the mediating role of parenting stress and the moderating role of social support from extended family. Methods: A cross-sectional analytical study was conducted in five regencies of West Java (N = 842 mother-child dyads). Children were aged 12–36 months. We utilized the Edinburgh Postnatal Depression Scale (EPDS) for depressive symptoms, the Parenting Stress Index-Short Form (PSI-SF) for stress, the Multidimensional Scale of Perceived Social Support (MSPSS) adapted for extended family, and the Ages and Stages Questionnaire (ASQ-3) for developmental monitoring. A moderated mediation model (Hayes Model 7) was tested using Structural Equation Modeling (SEM) with 5,000 bootstrap samples. Results: High maternal depressive symptoms were significantly associated with lower ECD scores (β = -0.42, p < 0.001). Parenting stress partially mediated this relationship (Indirect Effect = -0.18, 95% CI [-0.24, -0.13]). Crucially, extended family support moderated the path between depression and parenting stress (β = -0.15, p < 0.01). Specifically, the impact of depression on parenting stress was significantly dampened in households with high extended family engagement compared to those with low support. Conclusion: Parenting stress is a critical pathway through which maternal depression compromises child development. However, the collectivist family structure in West Java serves as a protective buffer. Interventions should target not only the mother but also mobilize the extended family network as a resource for 'kalyana mitra' (supportive friends/family).
Co-Authors Badrool Nizham Brenda Jaleel Dedi Sucipto Fachrudin Sani Fatimah Mursyid Habiburrahman Said Istiqomah Putri Lisye Tiur Simanjuntak Novalika Kurnia Oliva Azalia Putri Reisha Notonegoro Reza Andrianto Sophia Lucille Rodriguez Tanvir Ahmed Theresia Putri Sinaga Vania Delma Winata Putri