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Rachmat Hidayat
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Community Medicine and Education Journal
Published by HM Publisher
ISSN : -     EISSN : 27742962     DOI : https://doi.org/10.37275/cmej
Core Subject : Humanities, Health, Education,
Humanities Education Health Professions Languange, Linguistic, Communication & Media Public Health
CMEJ covers all subjects regarding community medicine and education. The covered research areas as follows community medicine, public health, epidemiology and biostatistics, health policy and administration, public health nutrition, environmental health, occupational health and safety, health promotion, reproductive health, maternal and child health, quality of life, health literacy and communication and their role in developing new healthcare programs, Arts of teaching, Case studies from schools around the world, Change management and education quality, Citizenship education, Classroom management, Computers in educational administration, Differing cultural perceptions of management in education, Distance education and multimedia environments, Early Childhood Education, Economics of education, Educational administration, Education environments (political, social, legal, cultural), Educational leadership, Educational policy and management, Educational systems planning/strategic planning, E-education / E-learning, Entrepreneurial development, Equity and education, Finance and accountability in education, Globalization and education, Human resources management, Individual professional learning portfolio, Information Communication Technologies (ICT) in Education, Special Education and Theories of educational management.
Arjuna Subject : Ilmu Sosial - Pendidikan
Articles 115 Documents
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Sustaining Infection Prevention and Control Post-Accreditation: A Systematic Review and Meta-Analysis of Global Longitudinal Outcomes Adhika Rahman; Siswanto Pabidang
Community Medicine and Education Journal Vol. 7 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.v7i1.872

Abstract

Hospital accreditation is globally recognized as a strategic framework for standardizing healthcare quality. However, the long-term efficacy of accreditation in sustaining Infection Prevention and Control (IPC) practices and reducing Healthcare-Associated Infections (HAIs) remains fiercely debated. Most existing literature relies on cross-sectional data, failing to capture the temporal stability of post-accreditation outcomes. A systematic review and meta-analysis were conducted following PRISMA guidelines. We analyzed longitudinal, interrupted time-series, and pre-and-post research articles evaluating IPC compliance and HAI incidence before, during, and after accreditation cycles. Data extraction focused on sample sizes, means, and standard deviations to calculate the Standardized Mean Difference (SMD) using a DerSimonian-Laird random-effects model. Heterogeneity was assessed via the I-squared statistic. Eight longitudinal studies encompassing varying international healthcare contexts were included. The pooled meta-analysis demonstrated a statistically significant, moderate improvement in IPC outcomes post-accreditation, with an overall SMD of 0.52 (95 percent Confidence Interval: 0.38 to 0.66, p < 0.001). Subgroup analyses revealed that structural IPC compliance measures showed higher effect sizes (SMD = 0.58) compared to direct clinical outcomes like HAI incidence density reductions (SMD = 0.42). Moderate heterogeneity was observed (I-squared = 54 percent). In conclusion, hospital accreditation acts as a significant catalyst for improving IPC metrics over time. The moderate effect size on direct clinical outcomes suggests that accreditation provides a structural foundation that must be coupled with continuous quality improvement and strong institutional leadership to prevent post-survey decay.
The Pentahelix Approach to Oral-Systemic Health Integration: A Policy Framework for Academic-Primary Care Partnerships in Transitional Health Systems Zelka Dapala; Rachmat Hidayat; Muhammad Ashraf
Community Medicine and Education Journal Vol. 6 No. 2 (2025): Community Medicine and Education Journal
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/cmej.v6i2.877

Abstract

The historical bifurcation of dental and medical care pathways imposes a severe epidemiological burden, particularly within transitional health systems confronting a high prevalence of both non-communicable diseases and chronic periodontitis. Bridging this gap requires robust policy frameworks that extend beyond clinical interventions to involve cross-sectoral collaboration. To evaluate the structural efficacy, clinical outcomes, and policy implications of integrating oral-systemic healthcare using a Pentahelix collaborative model between primary healthcare centers and academic dentistry institutions in South Sumatra, Indonesia. A mixed-methods implementation study was conducted over eighteen months across twelve primary care centers in South Sumatra. The intervention utilized the Pentahelix model, integrating government authorities, academic dentistry faculties, health technology industries, community leaders, and local media. Quantitative data included inter-departmental referral completion rates, changes in patient glycemic control (HbA1c), and systemic inflammatory markers (C-Reactive Protein). Qualitative data assessed stakeholder engagement and interprofessional competencies. Implementation of the Pentahelix framework significantly improved medical-dental cross-referral completion rates from a baseline of twelve percent to seventy-six percent. Clinically, patients with comorbid type 2 diabetes and severe periodontitis receiving integrated care demonstrated a mean HbA1c reduction of 0.9% and a significant decrease in serum C-Reactive Protein levels following combined medical and non-surgical periodontal therapy. Furthermore, interprofessional competency scores among participating academic students and primary care staff increased significantly. In conclusion, the Pentahelix model provides a viable, highly effective policy framework for dismantling clinical silos in transitional health systems. By anchoring interprofessional clinical practice within a multi-stakeholder governance structure, health systems can achieve measurable improvements in both population health metrics and health workforce readiness.
Short-Term Clinical Effects of Standardized Syzygium polyanthum (Bay Leaf) Tea Infusion on Serum Uric Acid Modulation in Hyperuricemia: A Pilot Trial in Primary Care Andi Asda Astiah; Isramilda; Deby Febriyanti
Community Medicine and Education Journal Vol. 7 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.v7i1.873

Abstract

Hyperuricemia management relies heavily on synthetic xanthine oxidase inhibitors, which possess adverse effect risks. This pilot trial evaluates the short-term clinical effects of a standardized Syzygium polyanthum (Indonesian bay leaf) tea infusion on serum uric acid levels in a primary care setting, standardizing conventional preparation methods. A quasi-experimental, pre- and post-test controlled pilot trial was conducted at a community health center on Sumatra Island, Indonesia. Twenty-four adults with hyperuricemia were purposively assigned (alternating days of presentation) to an intervention group (n=12) or a control group (n=12). The intervention comprised 2.0 grams of standardized S. polyanthum tea infused at 80 degrees Celsius for 1 to 3 minutes, consumed twice daily for seven days. Both groups underwent monitored dietary purine restriction. Serum uric acid was evaluated via capillary analysis. The intervention cohort exhibited a statistically significant reduction in median serum uric acid from 8.1 mg/dL (Interquartile Range [IQR]: 7.4–8.9) to 6.9 mg/dL (IQR: 6.2–7.5) (p=0.034). The control group showed no significant alteration (median 8.0 mg/dL to 7.9 mg/dL; p=0.299). Intervention compliance was 95.4%, with no adverse gastrointestinal events reported. In conclusion, standardized S. polyanthum tea infusion significantly reduces serum uric acid over seven days, presenting a culturally syntonic and safe complementary intervention for primary healthcare frameworks, though extended treatment may be required to reach optimal clinical targets below 6.0 mg/dL.
Religiosity, Spirituality, and Nonsuicidal Self-Injury Among Adolescents: A Meta-Analysis of Cross-Sectional and Longitudinal Studies Maya Aulya Saputri; Andrian Fajar Kusumadewi; Soewadi
Community Medicine and Education Journal Vol. 7 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.v7i1.881

Abstract

Nonsuicidal self-injury (NSSI) represents a growing public health concern among adolescents worldwide, with prevalence rates reaching 44.8% in Asian populations. Spirituality and religiosity have been proposed as protective factors against self-injurious behaviours; however, the quantitative evidence for this association has not been systematically synthesised with rigorous methodological standards. This meta-analysis aimed to evaluate the association between spirituality/religiosity and self-injurious behaviours in adolescents and young adults, and to clarify distinctions between NSSI and suicidal behaviour. A systematic search of multiple databases (PubMed, PsycINFO, CINAHL, Web of Science) was conducted using predefined search terms related to spirituality, religiosity, religion, self-injury, self-harm, NSSI, and adolescent populations. Original research articles reporting quantitative data on the association between spirituality/religiosity and self-injurious behaviours were included. Ten studies met inclusion criteria for qualitative synthesis, of which six provided sufficient quantitative data for meta-analysis. Effect sizes were converted to standardised mean differences (Hedges' g) and pooled using a random-effects model (DerSimonian-Laird). Risk of bias was assessed using an adapted Newcastle-Ottawa Scale. Prediction intervals (PI) were calculated alongside 95% confidence intervals (CI). The pooled standardised mean difference was −0.67 (95% CI: −1.12 to −0.21; 95% PI: −2.18 to 0.85; p = 0.004), indicating a protective effect of spirituality/religiosity against self-harm. Substantial heterogeneity was observed (I² = 96%; τ² = 0.30), reflecting variability in study designs, populations, outcome measures, and religiosity constructs. Sensitivity analyses confirmed directional consistency of findings, though studies differ considerably in effect magnitude. Subgroup analyses identified potential differences by study design (cross-sectional vs. longitudinal) and geographic region, though these require cautious interpretation given limited sample numbers (k = 6). Meta-regression was limited by small sample size and collinearity between study characteristics. In conclusion, spirituality and religiosity demonstrated a protective association with reduced self-injurious behaviours among adolescents and young adults. However, the substantial heterogeneity, predominantly observational evidence base, concentration in Western populations, and inability to distinguish NSSI from suicidal behaviour in all studies necessitate cautious interpretation. These findings support further investigation of spiritual assessment in adolescent mental health, though clinical implications must be tempered by methodological limitations. Well-designed prospective studies examining cultural context, mechanisms of action, and distinctions between NSSI phenotypes are required.
Adaptive Leadership and Evidence-Based Policy in Hospital Financial Crisis Management During Disruption: A Systematic Review and Meta-Analysis Katerine Katerine; Siswanto Pabidang
Community Medicine and Education Journal Vol. 7 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.v7i1.885

Abstract

Hospital financial resilience during crises requires adaptive leadership—the capacity to diagnose complex system challenges and mobilise sustained organisational change. Systematic evidence on adaptive leadership effectiveness in hospital crisis management remains fragmented. Objectives: To synthesise quantitative evidence on the effectiveness of adaptive leadership interventions for improving hospital organisational performance during financial and operational disruptions. Systematic review with meta-analysis using the PRISMA 2020 framework. We searched PubMed, ScienceDirect from 2017–2026 for studies examining adaptive leadership or resilience outcomes in hospital settings during financial or operational crises. Two independent reviewers extracted data and assessed risk of bias using Newcastle-Ottawa Scale (NOS). We estimated effect sizes (Hedges g) from 6 of 7 studies with estimated correlation coefficients (inter-rater reliability ICC=0.85), converted via d = 2r/√(1−r²). Random-effects meta-analysis used DerSimonian-Laird estimator. Certainty of evidence assessed via GRADE. Seven studies (k=7) contributed to meta-analysis; 10 to systematic review. Pooled standardised mean difference (SMD) = 0.467 (95% CI: 0.305–0.628, p<0.0001); I²=0% (Q=1.01, p=0.985). Effect remained robust in sensitivity analyses (leave-one-out: 0.445–0.493). Heterogeneity by study design minimal (Review k=3 SMD=0.476; Empirical k=2 SMD=0.438). GRADE assessment: moderate certainty (downgraded for indirectness and effect size estimation). In conclusion, adaptive leadership interventions show small-to-moderate evidence-supported effect on hospital organisational performance during crises. This effect persists across study designs and contexts despite methodological heterogeneity. This meta-analysis provides initial quantitative synthesis to guide hospital policy-makers and clinical leaders in crisis management strategy selection.

Page 12 of 12 | Total Record : 115

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