cover
Article Per Year (5 Year)
All
Home Page
OAI Link
Editorial Team
Contact
Reviewer
Google Scholar
Contact Name
-
Contact Email
harapan@unsyiah.ac.id
Phone
+62895600103060052
Journal Mail Official
harapan@unsyiah.ac.id
Editorial Address
School of Medicine Universitas Syiah Kuala Darussalam, Banda Aceh, 23111 Indonesia
Location
Kota banda aceh,
Aceh
INDONESIA
Narra J
Published by PT Narra Sains Indonesia
ISSN : -     EISSN : 28072618     DOI : https://doi.org/10.52225/narraj
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health
Narra J is a multidisciplinary journal and it is published three times (April, August, December) a year. The objective is to promote articles on infection, public health, global health, tropical infection, one health and diseases in tropics. Narra J publishes original research work across all disciplines of medicine and allied sciences, related to infection, public health, global health, tropical infection, one health and diseases in tropics. The journal publishes Original articles, Short Report, Review articles, and Letters to the Editor. All articles published in Narra J are peer-reviewed and published online for immediate access and citation. Narra J publishes the primary research papers, review articles, short communications and letters on topics but not limited to: Public health Global health Infection Tropical diseases One health Biomedical sciences Epidemiology and clinical epidemiology Molecular biology Environmental health Microbiology Pharmacological sciences Diseases in tropics
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 644 Documents
 61   62   63   64   65 
Impact of a lean management intervention on waiting time and service efficiency in gynecologic oncology surgical services in a national referral hospital in Indonesia: An interrupted time-series study with lean waste analysis Sri DR. Syarief; Sagiran Sagiran; Elsye M. Rosa
Narra J Vol. 6 No. 2 (2026): August 2026
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v6i2.3100

Abstract

Long surgical waiting times in gynecologic oncology reflect operational inefficiencies and limited operating room capacity, compromising timely care and patient outcomes. This study specifically focuses on gynecologic oncology surgical services at Dr. Hasan Sadikin Hospital, Bandung, a major national referral hospital in Indonesia. It evaluated the impact of lean-based dedicated operating slots on surgical waiting times and service efficiency. A mixed-methods explanatory sequential design was applied. Quantitative data comprised 24 monthly time points (12 pre-intervention and 12 post-intervention) and were analyzed using interrupted time series analysis, while qualitative data were obtained through in-depth interviews with seven key informants to explain operational changes after the intervention. The intervention introduced one specialized operating room and nine weekly elective surgery slots dedicated to gynecologic oncology. The results demonstrated a significant reduction in mean waiting time from 8.16 weeks pre-intervention to 3.64 weeks post-intervention. Interrupted Time Series Analysis (ITSA) showed a significant immediate level reduction following implementation, with an estimated change of -2.87 weeks, indicating an immediate reduction in surgical backlog. Trend analysis further demonstrated a significant post-intervention slope change (0.48), reflecting a modification in waiting time trajectory after implementation. Although a slight upward trend was observed afterward due to surgical throughput, waiting times remained substantially lower than in the pre-intervention period. Lean Waste analysis revealed reductions in waiting, overprocessing, and inter-unit coordination inefficiencies. These findings indicate that lean-oriented dedicated operating slots improve operational efficiency, enhance patient access, and minimize systemic waste in high-volume oncology surgical services. The study provides empirical evidence supporting structured scheduling and lean principles as effective strategies for improving time-sensitive surgical care in tertiary hospitals.
Bystander alertness, responsiveness, and barriers to providing first aid for sudden cardiac arrest in Indonesia: A preliminary community-based study Yohanes K. Windi; Loetfia D. Rahariyani; Nikmatul Fadilah; Eko R. Wiyatno
Narra J Vol. 6 No. 2 (2026): August 2026
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v6i2.3105

Abstract

Bystanders can play a critical role in improving survival after sudden cardiac arrest (SCA), yet hesitation and inaction remain common. The aim of this study was to assess bystander alertness, responsiveness, and barriers to providing first aid for SCA in an Indonesian community setting. A cross-sectional survey was conducted among 500 residents attending four Community Health Centers in Sidoarjo District, East Java, Indonesia. A structured, self-administered questionnaire assessed recognition of heart disease, perceptions of life-threatening cardiac conditions, intended responses to SCA, types of medical aid sought, reasons for not providing first aid, and specific first-aid actions. Data were analyzed using descriptive statistics and Chi-squared tests. Overall, respondents showed limited recognition of SCA as a distinct cardiac emergency and were more familiar with heart attack and coronary disease. Although SCA is highly time-critical, it was not commonly perceived as the most life-threatening heart condition. Most respondents preferred to seek medical help rather than provide immediate first aid, while direct bystander intervention was uncommon. Among those who would not intervene, fear of being blamed, lack of knowledge, and perceived incompetence were the main barriers. Among respondents willing to help, intended actions were more commonly directed toward waking the victim or using culturally familiar practices, whereas cardiopulmonary resuscitation (CPR) was rarely reported. Significant differences were observed across all assessed response domains (p<0.001). These findings indicate low community alertness and responsiveness to SCA in this Indonesian setting. Community-based SCA education, hands-only CPR training, clearer emergency response guidance, and culturally sensitive public messaging are needed to improve bystander readiness and reduce delays in first aid.
Compassion imbalance, resilience, and depressive symptoms among older stroke survivors: A moderated–moderated mediation analysis of neuroticism, compassion, and self-compassion Aye M. Thaw; Jiranan Griffiths; Tinakon Wongpakaran; Nahathai Wongpakaran; Joshua Tsoh; Montana Buntragulpoontawee; Kitti Thiankhaw; Nopdanai Sirimaharaj
Narra J Vol. 6 No. 2 (2026): August 2026
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v6i2.3106

Abstract

Post-stroke depression is a frequent and clinically important complication among stroke survivors, contributing to poorer functional recovery and reduced quality of life. The aim of this study was to examine the interrelationships among neuroticism, resilience, compassion, self-compassion, and depressive symptoms in older stroke survivors. Stroke survivors aged ≥50 years were recruited from outpatient clinics at Chiang Mai University Hospital, Thailand. Participants completed standardized questionnaires assessing neuroticism, resilience, compassion, self-compassion, and depressive symptoms. Pearson correlation, multiple regression, mediation, and moderated–moderated mediation analyses were conducted to examine direct, indirect, and conditional associations among these psychological constructs. A total of 142 patients were included in the final analysis. Neuroticism was positively correlated with depressive symptoms (r=0.412, p<0.01) and negatively correlated with resilience (r=−0.311, p<0.01), whereas resilience was negatively correlated with depressive symptoms (r=−0.400, p<0.01). Mediation analysis showed that resilience partially mediated the association between neuroticism and depressive symptoms (indirect effect of 0.098, 95%CI: 0.029–0.195). This indirect association was conditional on levels of compassion and self-compassion. Compassion significantly moderated the association between resilience and depressive symptoms (B=−0.018, p=0.003), and self-compassion moderated the association between compassion and depressive symptoms (B=−0.072, p=0.019). The moderated–moderated mediation model was significant, as indicated by the index of moderated–moderated mediation (index=−0.0096, 95%CI: −0.0230 to −0.0021). The indirect pathway through resilience was strongest among participants with higher compassion for others but lower self-compassion, suggesting a pattern of compassion imbalance. These findings indicate that resilience functions within a broader emotional context, in which the balance between compassion for others and compassion toward oneself may shape vulnerability to depressive symptoms after stroke. Incorporating self-compassion-based strategies into post-stroke rehabilitation may help strengthen psychological recovery and reduce depressive symptoms among older stroke survivors.
Herbal products for the prevention and management of 5-fluorouracil-induced oral mucositis: A systematic review of preclinical evidence Pocut Astari; Dewi F. Suniarti; Erik Idrus
Narra J Vol. 6 No. 2 (2026): August 2026
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v6i2.3110

Abstract

Oral mucositis is a painful and dose-limiting complication of chemotherapy, particularly in patients receiving 5-fluorouracil (5-FU). Herbal products have attracted increasing interest as supportive care candidates because of their antioxidant, anti-inflammatory, anti-apoptotic, and cytoprotective properties. This systematic review aimed to synthesize preclinical evidence on the effects and mechanisms of herbal products in 5-FU-induced oral mucositis models. A literature search was conducted in PubMed, Scopus, EBSCO, ScienceDirect, and ProQuest for studies published up to March 2026, following PRISMA guidelines. Eligible studies were in vitro studies, or studies with a clearly described in vitro component, that evaluated herbal extracts, multi-herbal formulations, or naturally derived plant-based compounds in 5-FU-induced oral mucositis models. Study reliability was assessed using the ToxRTool. Seven studies were included, comprising three in vitro-only studies and four combined in vitro–in vivo experimental studies published between 2014 and 2025. The evaluated products included Daiokanzoto, Salvia miltiorrhiza, Onchung-eum, anthocyanins from Oryza sativa, FITOPROT, cannabidiol, and Camellia tea saponin. Across the included studies, herbal products were reported to improve cell viability, reduce reactive oxygen species production, suppress inflammatory mediators, inhibit apoptosis, and promote epithelial repair. The main mechanisms involved the modulation of nuclear factor kappa-light-chain-enhancer of activated B cells signaling, caspase-3 activation, the Nrf2/Keap1/ARE pathway, mitochondrial dysfunction, and ferroptosis-related markers. All included studies were classified as reliable without restrictions, with ToxRTool scores ranging from 16 to 18. In conclusion, preclinical evidence suggests that herbal products may have protective effects against 5-FU-induced oral mucositis through antioxidant, anti-inflammatory, and cytoprotective mechanisms. However, standardized in vivo studies and clinical trials are needed before their therapeutic use can be recommended.

Page 65 of 65 | Total Record : 644

 61   62   63   64   65 

Filter by Year

2021 2026


Reset
Filter By Issues
All Issue Vol. 6 No. 2 (2026): August 2026 Vol. 6 No. 1 (2026): April 2026 Vol. 5 No. 3 (2025): December 2025 Vol. 5 No. 2 (2025): August 2025 Vol. 5 No. 1 (2025): April 2025 Vol. 4 No. 3 (2024): December 2024 Vol. 4 No. 2 (2024): August 2024 Vol. 4 No. 1 (2024): April 2024 Vol. 3 No. 1 (2023): April 20223 (In Press) Vol. 3 No. 3 (2023): December 2023 Vol. 3 No. 2 (2023): August 2023 Vol. 3 No. 1 (2023): April 2023 Vol. 2 No. 3 (2022): December 2022 Vol. 2 No. 2 (2022): August 2022 Vol. 2 No. 1 (2022): April 2022 Vol. 1 No. 3 (2021): December 2021 Vol. 1 No. 2 (2021): August 2021 Vol. 1 No. 1 (2021): April 2021 More Issue