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"Penggunaan komputer atau Visual Display Terminal VDT bertujuan meningkatkan efisiensi dan efektifitas kerja, disisi lain peningkatan intensitas pekerja dengan komputer dapat berpengaruh pada kesehatan antara lain menimbulkan stres kerja. Penelitian ini bertujuan dibuktikannya perbedaan stres kerja dengan gangguan otonom pada pegawai pengguna VDT dan non pengguna VDT di Instansi Pemerintah.Penelitian ini menggunakan desain comparative cross sectional dengan 224 orang responden yang dipilih melalui cluster random sampling. Pengukuran stres kerja dengan gangguan otonom menggunakan kuesioner Survey Diagnostic Stress SDS dan pengukuran Heart Rate Variability HRV . SDS digunakan untuk mendiagnosis stres kerja sedangkan HRV digunakan untuk mendiagnosis gangguan otonom. Dari 224 responden didapatkan prevalensi stres kerja dengan gangguan otonom pada pengguna VDT yaitu 19,1 dan prevalensi stres kerja dengan gangguan otonom pada non pengguna VDT yaitu 7,3 . Pengguna VDT mempunyai risiko lebih tinggi 2,99 kali untuk mengalami terjadinya stres kerja dengan gangguan otonom dibandingkan dengan non pengguna VDT OR = 2,99; 95 CI=1,27 ndash; 7,04 . Faktor faktor determinan yang berhubungan bermakna dengan stres kerja dengan gangguan otonom yaitu konflik peran p = 0,017; OR.adj = 3,96;95 CI = 1,28 -12,30 , tanggung jawab personal p = 0,022; OR.adj = 3,79; 95 CI = 1,28 -11,82 dan pengguna VDT p = 0,027; OR.adj = 2,37; 95 CI = 1,12 - 6,66 . Pegawai pada Instansi Pemerintah yang bekerja menggunakan VDT memiliki risiko lebih tinggi untuk mengalami stres kerja dengan gangguan otonom dibandingkan pegawai non pengguna VDT.

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The use of computer or Visual Display Terminal VDT is aimed at improving working efficiency and effectiveness, however, the increasing use of computer among workers can also affects their health, one of which is causing job stress. This study is aimed at proving the difference between job stress with autonomic disorder among VDT users and non VDT users at Central Goverment Institutions.This study used a comparative cross sectional design with 224 respondents selected through cluster random sampling. Job stress with autonomic disorder is measured by Stress Diagnostic Survey SDS questionnaire and Heart Rate Variability HRV . SDS is used to diagnose job stres while HRV is used to diagnose autonomic disorder. Out of the 224 respondents, the prevalence of job stress with autonomic disorder among VDT users is 19.1 and prevalence of job stress with autonomic disorder among non VDT users is 7.3 . VDT users have a higher risk 2.99 times to experience job stress with autonomic disorder compared to the non VDT users OR 2.99 95 CI 1.27 ndash 7.04. Determinant factors which have significant correlation with job stress with autonomic disorder are role conflict p 0.017 OR.adj 3.96 95 CI 1.28 12.30 , personel responsibility p 0.022 OR.adj 3.79 95 CI 1.28 11.82 and VDT users p 0.027 OR.adj 2.37 95 CI 1.12 ndash 6.66 .Workers at Government Institutions working with VDT have a higher risk to experience job stress with autonomic disorder compared to the non VDT users. Keywords Job stres with autonomic disorder VDT Survey Diagnostic Stres Heart Rate Variability."

"[ABSTRAKLatar Belakang: Kusta merupakan penyakit infeksi penyebab neuropati perifer paling sering. Neuropati otonom merupakan salah satu neuropati perifer yang perlu dideteksi dini dengan pemeriksaan sederhana untuk mencegah kecacatan lebih lanjut karena memiliki gejala subklinis. Tujuan: Menguji sensitivitas dan spesifisitas pemeriksaan Stimulated Skin Wrinkle (SSW) terhadap Sudoscan dalam mendeteksi neuropati otonom pada kusta multibasiler. Metode penelitian: Penelitian menggunakan uji diagnostik pemeriksaan SSW terhadap Sudoscan pada penderita kusta multibasiler yang telah didiagnosis di poliklinik Kulit dan Kelamin RS Cipto Mangunkusumo, Jakarta. Penelitian dilakukan selama tiga bulan (Maret-Mei 2015). Anamnesis, pemeriksaan fisik, SSW dengan krim Eutectic mixture of local anesthetic (EMLA), dan Sudoscan dilakukan pada setiap subjek penelitian. Hasil dianalisis untuk mendapatkan nilai sensitivitas dan spesifisitas. Hasil: Diperoleh 70 subyek penelitian. Prevalensi gangguan otonom berdasarkan pemeriksaan SSW, Sudoscan dan klinis berturut-turut sebesar 64.3%, 32.9% dan 85.7%. Berdasarkan kurva ROC pemeriksaan SSW terhadap Sudoscan, didapatkan nilai AUC sebesar 0,779. Setelah diuji dengan tabel 2x2 didapatkan nilai sensitivitas 95.7%, spesifisitas 51.1%, nilai prediksi positif 48.9% dan nilai prediksi negatif 96%. Kesimpulan: Pemeriksaan SSW dapat menjadi pemeriksaan penyaring yang sederhana dalam mendeteksi neuropati otonom pada kusta tipe multibasiler, dengan sensitivitas yang tinggi.

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ABSTRACTBackground: Leprosy is the commonest infectious disease causes peripheral neuropathy. Autonomic neuropathy is a peripheral neuropathy that is important to detect with a simple examination to prevent further disability because the subclinical manifestation. Objective: Examine the sensitivity and specificity of Stimulated Skin Wrinkle (SSW) examination against Sudoscan to detect autonomic neuropathy in multibacillary leprosy. Method: The study consists of diagnostic test of SSW examination upon Sudoscan among multibacillary leprosy patients previously diagnosed in the Dermatology & Venerealogy Clinic in Cipto Mangunkusumo Hospital, Jakarta. The study was conducted in three months (March-May 2015). History, physical examination, SSW with Eutectic mixture of local anesthetic (EMLA) cream, and Sudoscan was performed upon every subject. Results are analyzed to obtain sensitivity and specificity level. Results: There are 70 subjects participated. Prevalence of autonomic disturbance by SSW, Sudoscan and clinical are 64.3%, 32.9% and 85.7% respectively. Based on ROC curve of the SSW examination against Sudoscan, the obtained AUC value is 0.779. After testing with chi-square, the following values were obtained: sensitivity 95.7%, specificity 51.1%, positive predictive value 48.9%, and negative predictive value 96%. Conclusion: SSW examination is a simple screening test that can detect autonomic neuropathy among multibacillary leprosy, with high sensitivity.;Background: Leprosy is the commonest infectious disease causes peripheral neuropathy. Autonomic neuropathy is a peripheral neuropathy that is important to detect with a simple examination to prevent further disability because the subclinical manifestation. Objective: Examine the sensitivity and specificity of Stimulated Skin Wrinkle (SSW) examination against Sudoscan to detect autonomic neuropathy in multibacillary leprosy. Method: The study consists of diagnostic test of SSW examination upon Sudoscan among multibacillary leprosy patients previously diagnosed in the Dermatology & Venerealogy Clinic in Cipto Mangunkusumo Hospital, Jakarta. The study was conducted in three months (March-May 2015). History, physical examination, SSW with Eutectic mixture of local anesthetic (EMLA) cream, and Sudoscan was performed upon every subject. Results are analyzed to obtain sensitivity and specificity level. Results: There are 70 subjects participated. Prevalence of autonomic disturbance by SSW, Sudoscan and clinical are 64.3%, 32.9% and 85.7% respectively. Based on ROC curve of the SSW examination against Sudoscan, the obtained AUC value is 0.779. After testing with chi-square, the following values were obtained: sensitivity 95.7%, specificity 51.1%, positive predictive value 48.9%, and negative predictive value 96%. Conclusion: SSW examination is a simple screening test that can detect autonomic neuropathy among multibacillary leprosy, with high sensitivity., Background: Leprosy is the commonest infectious disease causes peripheral neuropathy. Autonomic neuropathy is a peripheral neuropathy that is important to detect with a simple examination to prevent further disability because the subclinical manifestation. Objective: Examine the sensitivity and specificity of Stimulated Skin Wrinkle (SSW) examination against Sudoscan to detect autonomic neuropathy in multibacillary leprosy. Method: The study consists of diagnostic test of SSW examination upon Sudoscan among multibacillary leprosy patients previously diagnosed in the Dermatology & Venerealogy Clinic in Cipto Mangunkusumo Hospital, Jakarta. The study was conducted in three months (March-May 2015). History, physical examination, SSW with Eutectic mixture of local anesthetic (EMLA) cream, and Sudoscan was performed upon every subject. Results are analyzed to obtain sensitivity and specificity level. Results: There are 70 subjects participated. Prevalence of autonomic disturbance by SSW, Sudoscan and clinical are 64.3%, 32.9% and 85.7% respectively. Based on ROC curve of the SSW examination against Sudoscan, the obtained AUC value is 0.779. After testing with chi-square, the following values were obtained: sensitivity 95.7%, specificity 51.1%, positive predictive value 48.9%, and negative predictive value 96%. Conclusion: SSW examination is a simple screening test that can detect autonomic neuropathy among multibacillary leprosy, with high sensitivity.]"

"Latar Belakang: Penyakit Graves paling banyak diderita anak hipertiroid dengan akibat tumbuh kembang anak terganggu. Metode pengobatan optimal hipertiroid Graves saat ini masih dalam perdebatan. ATD masih digunakan oleh sebagian besar tenaga kesehatan. Relaps dengan ATD dapat mencapai 83% dengan pengobatan ATD. Pengalihan metode terapi salah satunya berdasarkan relaps. Pengalihan terapi saat awal dari ATD ke metode pengobatan lain pada anak yang diprediksi relaps akan menghemat waktu dan biaya serta meningkatkan potensi tumbuh kembang anak. Tujuan: Mengetahui insidens relaps hipertiroid Graves anak dan hubungannya terhadap kadar awal FT4 serta karakteristik usia dan jenis kelamin penderita. Metode: Penelitian bersifat kohort retrospektif dengan menelusuri data rekam medis pasien berusia 1-18 tahun mulai Januari 2000 hingga Juni 2013 di RS Cipto Mangunkusumo, RS Hermina Jatinegara, Bekasi dan Podomoro. Data ditabulasi untuk mendapatkan insiden relaps, median kadar awal FT4, median usia dan jenis kelamin penderita relaps. Analisis statistik dilakukan untuk mencari pengaruh kadar awal FT4 terhadap insiden relaps. Hasil: Penelitian dilakukan terhadap 25 subjek dengan 12 anak mengalami relaps. Kadar awal FT4 terhadap insiden relaps ditemukan tidak bermakna secara statistik (p=0,64) namun kelompok relaps cenderung memiliki kadar awal FT4 lebih tinggi. Relaps dialami lebih banyak oleh anak perempuan (3:1) dengan median usia 10,9 tahun. Penelitian ini mendapatkan hasil lain yaitu durasi eutiroid berbeda bermakna terhadap insiden relaps (p=0,002). Simpulan: Insiden relaps hipertiroid Graves anak 12/25 dengan kadar awal FT4 tidak bermakna secara statistik walau terdapat kecenderungan kadar awal FT4 lebih tinggi pada kelompok relaps. Relaps lebih banyak dialami anak perempuan (3:1) dengan median usia 10,9 tahun.

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Background: Graves disease is most common causes in children with hyperthyroidism which affect growth and development. Optimal initial treatment method of hyperthyroid Graves in children is still under debate. Anti-thyroid drug (ATD) is still used as the initial treatment by the majority of health workers. Relapse can reach 83% with ATD treatment; and relapse is one of the causes to adjust therapeutic method. Alteration of initial ATD therapy to other treatment methods, in children who predicted relapse, will save time and costs as well as potentiate children’s growth and development.

Aim: To investigate the incidence of Graves hyperthyroidism relapse and its relationship to the initial FT4 levels, as well as age and gender characteristics of patients.

Method: This study is a retrospective cohort by investigate medical records of patients aged 1-18 years from January 2000 to June 2013 at Cipto Mangunkusumo hospital, Hermina Jatinegara Bekasi and Podomoro Hospital. Data were tabulated to obtain the incidence of relapse, the median of initial FT4 levels, the median of age, and sex of relapse patient. Statistical analysis was performed to find the effect of initial FT4 levels on the incidence of relapse.

Result: The study was conducted on 25 subjects with 12 children experienced a relapse. Initial FT4 levels of relapse patients was found statistically insignificant (p=0,64), but the relapse group tended to have higher levels of initial FT4. Relapse is predominant in girls (3:1), with median age of 10.9 years. This study found that duration of euthyroid differ significantly in the incidence of relapse (p=0,002).

Conclusion: The incidence of hyperthyroid Graves relapse in children is 12/25 with inital FT4 levels were not statistically significant although there was tendency initial FT4 levels were higher in relapse group. Girls experienced more relapses (3:1) with median age of 10.9 years."

"Adanya pandemi COVID-19 memberikan dampak terhadap peningkatan penggunaan pada beberapa layanan digital, salah satunya adalah aplikasi SVoD. Salah satu pricing model yang mulai banyak digunakan oleh industri SVoD adalah freemium model, di mana pengguna dapat menonton dengan dua pilihan akun, yaitu melalui akun gratis atau akun premium. Penelitian ini bertujuan untuk mengidentifikasi faktor push, pull, dan mooring yang memengaruhi switching intention dari free-to-fee user pada aplikasi Subscription Video on Demand di Indonesia. Teori yang digunakan pada penelitian ini adalah teori Push-Pull-Mooring (PPM) sebagai teori yang banyak digunakan pada penelitian terkait switching intention. Penelitian ini memiliki 475 responden valid yang pernah berlangganan akun premium setidaknya sekali pada aplikasi SVoD. Analisis data dilakukan dengan menggunakan metode Covarianced-based Structural Equation Model dan menggunakan bantuan program AMOS 26. Hasil penelitian ini menunjukkan bahwa intrusiveness of advertising dan limited content tidak berpengaruh terhadap switching intention. Sementara itu, premium attractiveness of utilitarian benefits, premium attractiveness of hedonic benefits, price value, switching cost, peer influence, dan habit berpengaruh terhadap switching intention. Pada faktor moderasi, hanya hubungan premium attractiveness of utilitarian benefits dan price value dengan switching intention yang dimoderasi oleh variabel habit. Berdasarkan hal tersebut, penelitian ini diharapkan dapat memberikan kontribusi bagi perusahaan penyedia layanan SVoD untuk mengevaluasi layanan mereka sehingga semakin banyak pengguna yang beralih dari akun gratis ke akun premium.

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The COVID-19 pandemic was increasing some of digital services usage, one of them is the SVoD application. One of the pricing models that the SVoD industry has started to use is the freemium model, where users can watch with two choices of accounts, a free account or a premium account. This study aims to identify the push, pull, and mooring factors that influence the switching intention from free-to-fee users in the Subscription Video on Demand application in Indonesia. The theory used in this study is the theory of Push-Pull-Mooring (PPM) as a theory that is widely used in research related to switching intention. This study has 475 valid respondents who have subscribed to a premium account at least once on the SVoD application. The data were analyzed using the Covarianced-based Structural Equation Model method and using the AMOS 26 program. This study indicates that the intrusiveness of advertising and limited content has no effect on user’s switching intention. Meanwhile, premium attractiveness of utilitarian benefits, premium attractiveness of hedonic benefits, price value, switching costs, peer influence, and habit have an effect on user’s switching intention. On the moderating factor, only the premium attractiveness of utilitarian benefits and price value with switching intention is moderated by the habit variable. Based on this result, this research is expected to contribute to SVoD service provider companies to evaluate their services so they can gain more users to switch from free accounts to premium accounts

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"Latar Belakang: Dosen, tenaga kependidikan, dan staf lainnya di perguruan tinggi seringkali menghadapi beban kerja yang besar dalam melaksanakan pekerjaannya. Beban kerja yang besar dapat mengarah ke pengabaian perilaku sehat seperti istirahat yang cukup, olahraga, makan teratur, dan pengelolaan stress. Kebiasaan kurang sehat tersebut dapat menyebabkan gangguan keseimbangan otonom sebagai regulator fungsi organ internal yang kemudian mengarah ke kondisi patologis seperti gangguan metabolik, salah satunya pada regulasi glukosa darah.  Studi ini mengeksplorasi hubungan antara status fungsional sistem saraf otonom berdasarkan Index of Regulation System Activity (IRSA) sebagai salah satu alat ukur status fungsional sistem saraf otonom yang praktis digunakan dan faktor-faktor lainnya terhadap glukosa darah puasa pada pegawai perguruan tinggi sehingga dapat menyajikan pendekatan baru dalam mendeteksi risiko gangguan metabolisme glukosa. Metode: Penelitian ini menggunakan desain observasional potong lintang pada karyawan Fakultas X, Universitas Y. Pengambilan data melibatkan pengukuran IRSA dan profil glukosa darah dari data sekunder pemeriksaan kesehatan tahun 2022. Analisis statistik menggunakan metode univariat, bivariat, dan multivariat untuk menilai hubungan antara variabel studi. Hasil: Hasil pemeriksaan IRSA didapatkan sebanyak 151 pegawai (67,4%) memiliki status fungsional kondisi prenosologis-premorbid, 48 pegawai (21,4%) pada status fungsional fisiologis normal, dan 25 pegawai (11,2%) pada status fungsional kegagalan adaptasi. Pada pemeriksaan glukosa darah puasa, didapatkan 36 pegawai (16,1%) memiliki glukosa darah puasa ≥ 100 mg/dL. Status fungsional kegagalan adaptasi (p=0,001; OR=26,43; 95% CI = 3,10-225,25) dan juga status fungsional prenosologis-premorbid (p=0,001 OR=9,78; 95% CI = 1,29-74,08) memiliki hubungan yang bermakna dengan glukosa darah puasa. Kesimpulan: Pekerja  dengan IRSA abnormal memiliki kecenderungan lebih besar memiliki glukosa darah puasa ≥ 100 mg/dL jika dibandingkan dengan pegawai dengan status fungsional IRSA fisiologis normal. Diperlukan tidak lanjut dari hasil pemeriksaan kesehatan secara berkesinambungan dan holistik baik untuk individu maupun kelompok yang disesuaikan dengan karakteristik dan resiko sasaran demi kesehatan serta produktivitas pekerja.

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Background: Faculty members, educational staff, and other university personnel often face significant workloads in performing their duties. Work overload can lead to unhealthy behaviors and stress which can disturb the autonomic balance. These unhealthy habits can disturb the autonomic balance leading to pathological conditions such as metabolic disorders, including blood glucose metabolism. This study aims to find the relationship between the functional status of the autonomic nervous system based on the Index of Regulation System Activity (IRSA) to fasting blood glucose (FBG) levels in university employees. Method: This observational cross-sectional study used the secondary data of university employees medical checkups (MCU) in 2022 with total sample of 242 people. Variables included were IRSA from Heart Rate Variability (HRV) examination, FBG level, and other sociodemographic profiles. The MCU was conducted in the university hospital. Results: The examination results of IRSA indicated that 151 employees (67.4%) had a prenosologic-premorbid functional status and 25 employees (11.2%) had a failure of adaptation functional status. FBG examination revealed that 36 employees (16.1%) had FBG levels of ≥ 100 mg/dl. Failure of adaptation functional status had a significant relationship with FBG (p=0.003; OR=26.43; 95% CI = 3.10-225.25), as well as prenosological-premorbid functional status (p=0.03; OR=9.78; 95% CI = 1.29-74.08). Conclusion: Employees with abnormal IRSA were more likely to have FBG levels ≥ 100 mg/dL compared to those with normal physiological functional status. Ongoing and holistic monitoring of health examination outcomes is essential, catered to the specific characteristics and risk profiles of both individual and group targets, aiming to maintain and enhance worker health and productivity."

"Pendahuluan: Pemilu 2019 di Indonesia merupakan pemilu pertama yang dilaksanakan serentak dan Kelompok Penyelenggara Pemungutan Suara (KPPS) harus menyelesaikan penghitungan suara di hari yang sama dengan penambahan kertas suara. Keadaan ini menyebabkan petugas KPPS meninggal dan sakit diduga akibat stres dan kelelahan akibat beban kerja yang berlebihan. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan respon stres pada petugas KPPS Pemilu 2019.  Metode: Desain studi potong lintang menggunakan data sekunder dilakukan terhadap masalah yang diteliti meliputi 80 data petugas KPPS di TPS di Jakarta, Banten, dan Yogyakarta. Stresor kerja dan respons stres dinilai dengan NBJSQ bahasa Indonesia. Beberapa model regresi logistik digunakan untuk mengeksplorasi faktor-faktor yang terkait dengan respons stres.Hasil: Stresor pekerjaan yang paling dirasakan oleh petugas KPPS Pemilu 2019 dalam penelitian ini adalah kelebihan beban kerja kuantitatif (47,5). Respon stres yang paling banyak terjadi pada petugas KPPS Pemilu 2019 dalam penelitian ini adalah kelelahan (17,5%). Tidak ada hubungan antara stresor pekerjaan dan faktor individu dengan respon stres (p>0,05).Kesimpulan: Penelitian ini menunjukkan bahwa kelebihan beban kerja kuantitatif merupakan stresor kerja utama di kalangan petugas KPPS pada pemilihan umum 2019. Stresor tersebut dapat memicu kejadian serangan jantung pada individu yang memiliki predisposisi.

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Introduction: The 2019 general election in Indonesia was the first general election to be held simultaneously and election officers (KPPS) had to complete the vote count on the same day with additional ballot papers. This situation caused high mortality and morbidity among KPPS officers due to stress and fatigue caused by job overload. This study was aimed to explore the factors related stress response in 2019 election KPPS officers.

Methods: A cross-sectional study design was conducted to the issue under the study included 80 data of KPPS officers at Polling Station (TPS) in Jakarta, Banten, and Yogyakarta. Occupational stressor and stress response was assesed with NBJSQ bahasa Indonesia. Multiple logistic regression models were used to explore factors associated with stress response.

Results: The most perceived occupational stressor experienced by the 2019 General Election KPPS officers in this study were quantitative job overload (47,5%).The stress response that occurred in the 2019 General Election KPPS officers in this study was fatigue (17.5%). There was no relationship between occupational stressor and individual factors with stress response (p>0.05). The stressor can trigger the incidence of heart attacks in predisposed individuals."

"Beban kompleks ventrikel prematur (KVP) memiliki tiga jenis ritme sirkadian, yaitu tipe cepat, tipe lambat, dan tipe independen. Nukleus suprakiasmatikus merupakan bagian dari hipotalamus dan berperan sebagai pusat yang mengatur ritme sirkadian tubuh. Nukleus suprakiasmatikus berhubungan dengan sumbu hipotalamus-pituitari-adrenal (HPA), sistem saraf autonom, dan aspek psikologis. Hubungan ketiga sistem ini dengan ritme sirkadian beban KVP belum diketahui. Oleh karena itu, perlu dilakukan penelitian untuk menganalisis hubungan sumbu HPA, sistem saraf autonom, dan aspek psikologis dengan ritme sirkadian beban KVP. Studi observasional potong lintang ini merekrut subjek penelitian di RS Jantung dan Pembuluh Darah Harapan Kita, RSUD Pakuhaji, dan RS Bun. Waktu penelitian adalah dari Juli 2022 sampai Desember 2022. Kriteria inklusi adalah pasien KVP idiopatik dengan beban ≥ 5%. Sebanyak 23 subjek KVP tipe-cepat, 20 subjek KVP tipe-lambat, 22 pasien KVP tipe-independen, dan 5 subjek kontrol diikutsertakan pada penelitian. Setiap subjek menjalani pemeriksaan Holter 24 jam untuk evaluasi beban KVP dan heart rate variability, mengumpulkan saliva untuk pemeriksaan kortisol dan norepinefrin pada pukul 06:00–07:00, 10:00–11:00, dan 22:00–23:00, serta mencatat skala kesehatan subjektif. Selanjutnya, dilakukan analisis univariat dan regresi linier multipel untuk menganalisis hubungan antara ritme sirkadian variabel independen dan ritme sirkadian beban KVP. Hasil pemeriksaan Holter menunjukkan bahwa rerata beban KVP idiopatik tipe-cepat adalah 15,7%; tipe-lambat 8,4%; dan tipe-independen 13,6%. Regresi liner multipel menunjukkan bahwa tingginya beban KVP idiopatik-tipe-cepat berhubungan dengan kadar kortisol yang lebih tinggi dan tonus sistem saraf parasimpatis yang lebih rendah. Di samping itu, tingginya beban KVP idiopatik-tipe-lambat berkaitan dengan kadar kortisol dan tonus sistem saraf simpatis yang lebih rendah atau tonus sistem saraf parasimpatis yang lebih tinggi. Sementara itu, pada KVP idiopatik-tipe-independen tingginya beban KVP berhubungan dengan kadar kortisol dan tonus sistem saraf simpatis yang lebih tinggi atau tonus sistem saraf parasimpatis yang lebih rendah serta skala kesehatan subjektif yang lebih rendah. Disimpulkan bahwa pola sirkadian beban KVP idiopatik tipe cepat, lambat, dan independen masing-masing berhubungan secara khas dengan sumbu HPA, sistem saraf autonom dan mekanisme psikologis. Penilaian tipe ritme sirkadian KVP idiopatik perlu dilakukan secara rutin mengingat perbedaan mekanisme yang mendasarinya dan kemungkinan perbedaan pada prognosisnya.

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Recent data show that premature ventricular complex (PVC) burden exhibits one of the three circadian patterns, namely fast-type, slow-type, and independent-type PVC. The suprachiasmatic nucleus is part of the hypothalamus and serves as the center of circadian rhythm regulation. The suprachiasmatic nucleus is related to the hypothalamus-pituitary-adrenal (HPA) axis, the autonomic nervous system, and psychological aspects. The relationship between these three systems and the circadian rhythm of PVC is unknown. Therefore, it is important to evaluate the relationship between the HPA axis, the autonomic nervous system, and psychological aspects with the circadian rhythm of PVC burden. This cross-sectional observational study recruited 23 fast-, 20 slow-, and 22 independent-type idiopathic PVC subjects, as well as 5 control subjects. Each subject underwent a 24-hour Holter to examine PVC burden and heart rate variability, collected saliva for cortisol and norepinephrine level measurement at 6–7 am, 10–11 am, and 10–11 pm, and recorded their self-rated health scales. Furthermore, univariate and multiple linear regression were conducted to investigate the associations between circadian rhythms of the independent variables and circadian rhythms of PVC burden. The results of the Holter monitor showed that the average PVC burden was 15.7%, 8.4%, and 13.6% respectively in fast-, slow-, and independent-type idiopathic PVCs. Multiple linear regression showed that the high burden of fast-type idiopathic PVC was assosciated with higher cortisol levels and lower parasympathetic nervous system tone. On the other hand, the high burden of slow-type idiopathic PVC was associated with lower cortisol levels and lower sympathetic nervous system tone. Meanwhile, in independent-type idiopathic PVC, the high burden was associated with higher cortisol levels and sympathetic nervous system tone as well as lower self-rated health scales. The results of this study indicate that each circadian pattern of idiopathic PVC burden is uniquely related to the HPA axis, the autonomic nervous system and psychological mechanisms. Assessment of idiopathic PVC circadian rhythm types needs to be carried out routinely considering the differences in the underlying mechanisms and the possible differences in the prognosis."

"Latar belakang. Pandemi Covid-19 membawa perubahan yang dilakukan pemerintah untuk menekan penyebaran Covid-19 sehingga diberlakukan aturan Work From Home (WFH) bagi dunia kerja. Saat kasus Covid-19 mulai menurun, perkantoran perlahan mulai kembali ke Work From Office (WFO). Perubahan sebelum dan selama pandemi Covid-19 menimbulkan tekanan yang membuat persepsi tertentu terhadap stres dan stressor kerja setiap saat.Metode. Penelitian dilakukan di Kantor Pelayanan Pajak Tangerang dengan menggunakan metode campuran, metode kuantitatif digunakan untuk mendapatkan gambaran deskriptif stres kerja dan stresor menggunakan kuesioner SV-NBJSQ (Short Version New Brief Job Stres Questionnaire) versi bahasa Indonesia dan metode kualitatif dengan wawancara mendalam semi terstruktur untuk mendapatkan gambaran persepsi pekerja terhadap stres kerja dan stresor di masa sebelum dan selama pandemi Covid-19.Hasil. Prevalensi stres kerja saat WFO masa pandemi Covid-19 sebesar 28%, dengan gejala stres kerja yaitu kurangnya vigor sebesar 18.3 %, kelelahan 12.2%, kecemasan 9.8%, dan stres reaksi fisik 3.7%. Hasil stresor kerja adalah tuntutan emosional 31.7%, konflik peran 28 % , keseimbangan kerja negatif  24.4%, dan kelebihan beban kuantitatif 15.4%. Didapatkan kategori persepsi stres dan stresor kerja di masa sebelum pandemi Covid-19, WFH dan WFO masa pandemi Covid-19 sesuai dengan kata kuncinya.Kesimpulan. Wawancara mendalam dapat menggali jawaban kuesioner tentang gejala stres yang ada dan penyebab stres yang mendasarinya. Terdapat perbedaan dan persamaan persepsi stres dan stresor kerja pada pekerja pelayanan publik saat sebelum dan selama pandemi Covid-19 yang selanjutnya dapat menjadi pertimbangan bagi perusahaan yang akan terus dapat mengalami perubahan akibat pandemi Covid-19 yang masih belum berakhir.

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Background. The Covid-19 pandemic has brought changes  that made by the government to suppress the spread of Covid-19 so that Work From Home (WFH) regulation were held for the world of work. As  Covid-19 cases began to decline, offices slowly began going back to the Work From Office (WFO). Changes before and during the Covid-19 pandemic created a pressure that made certain perceptions of stress and work stressors at all times.

Method. The research was carried out at the Tax Service Office in Tangerang using a mixed method where quantitative methods are used to get a descriptive picture of work stress and stressors using the Indonesian version of the SV-NBJSQ ( Short Version New Brief Job Stres Questionnaire) and qualitative methods with semi-structured in-depth interviews to obtain in period before, during the WFH, along with the WFO Covid-19 pandemic to workers in public service offices.

Results. The prevalence of work stress during WFO during the Covid-19 pandemic was 28%, with the results of work stress in the form of low vigor of 18.3%, fatigue of 12.2%, anxiety of 9.8%, stress of physical reactions 3.7%. The results of work stressors are emotional demands 31.7%, role conflict 28%, negative work balance 24.4%, and quantitative load 15.4%. The categories of perception stress and work stressors were obtained before the Covid-19 pandemic, WFH and WFO during the Covid-19 pandemic according to the keywords.

Conclusion. In-depth interviews could explore the questionnaire answers about existing stress symptoms and the underlying stressors. There are differences and similarities between perceptions of stress and work stressors for public service workers before, and during the Covid-19 pandemic which could then be a factor of consideration for companies that will necessarily continue to experience changes due to the Covid-19 pandemic which currently is still happening."

"Otitis media supuratif kronik (OMSK) merupakan salah satu gangguan telinga yang sering menimpa anak dan dapat menyebabkan gangguan pendengaran dan penurunan kualitas hidup, serta banyak komplikasi. Kondisi yang terkait dengan OMSK di antaranya alergi, hipertrofi adenoid, dan refluks laringofaring (RLF). Refluks laringofaring pada anak belum banyak dipelajari di Indonesia, dan diagnosis RLF berdasarkan Instrumen Tanda dan Gejala Refluks belum banyak dipelajari. Kejadian RLF juga dikaitkan dengan gangguan saraf autonom, akibat gangguan nervus vagus yang dapat menyebabkan refluksat lambung naik ke nasofaring dan mencapai muara tuba.Penelitian ini bertujuan untuk mengetahui hubungan RLF dengan OMSK tipe aman aktif yang dibahas desain 1 penelitian, yaitu studi kasus kontrol yang menganalisis alergi, hipertrofi adenoid, dan RLF sebagai faktor risiko OMSK tipe aman aktif. Desain kedua penelitian adalah studi kasus kontrol untuk mengetahui hubungan gangguan saraf autonom dengan kejadian RLF. Desain ketiga penelitian merupakan kohort retrospektif untuk mengetahui hubungan RLF dengan gangguan fungsi tuba. Penelitian dilaksanakan Mei 2023–Juni 2024, menyertakan 39 subjek OMSK tipe aman aktif dan 39 subjek kontrol dari pasien Poliklinik THT-KL RSCM, dan direkrut secara consecutive sampling. Subjek juga akan diperiksa kondisi RLF dan gangguan saraf autonom.Hasil penelitian menunjukkan bahwa anak dengan RLF terbukti berisiko 5,59x lebih tinggi untuk terkena OMSK tipe aman aktif (OR: 5,59; 95%CI: 1,247–25,049; p = 0,025). Alergi (OR: 1,433; 95%CI: 0,343–5,981; p = 0,622) dan hipertrofi adenoid (OR: 1,178; 95%CI: 0,584–2,378; p = 0,646) tidak terbukti bermakna secara statistik sebagai faktor risiko OMSK tipe aman aktif. Gangguan saraf autonom juga belum terbukti secara statistik sebagai faktor risiko RLF (OR: 1,086; 95%CI: 0,444– 2,650; p = 0,856). Refluks laringofaring juga tidak terbukti menjadi faktor risiko gangguan fungsi tuba (RR: 1,558; 95%CI: 0,594–4,087; p = 0,367). Dapat disimpulkan bahwa RLF merupakan faktor risiko utama OMSK tipe aman aktif pada anak. Pepsin dan derajat keasaman dari refluksat RLF pada telinga tengah dapat berperan dalam kerusakan telinga tengah.

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Chronic suppurative otitis media (CSOM) is a prevalent ear disorder in children that can lead to hearing impairment, a decline in quality of life, and various complications. Conditions associated with CSOM include allergy, adenoid hypertrophy, and laryngopharyngeal reflux (LPR). The incidence of LPR in children has not been extensively studied in Indonesia, and diagnosis of LPR based on Reflux Symptom and Sign Instrument is yet to be studied. LPR has also been linked to autonomic nervous system dysfunction, as disturbances in the vagus nerve can result in the reflux of gastric contents into the nasopharynx and the opening of the Eustachian tube.

This study aims to investigate the relationship between LPR and active benign type CSOM with the first design being a case-control study that analyzes allergy, adenoid hypertrophy, and LPR as risk factors for active benign type CSOM. The second design, also a case-control study, is to determine the association between autonomic nervous system dysfunction and the occurrence of LPR. The third study design employs a retrospective cohort study to assess the relationship between LPR and Eustachian tube function disorders. The research is conducted from May 2023 to June 2024, including 39 subjects with active benign type CSOM and 39 control subjects from the ENT-HN Polyclinic of RSCM, recruited through consecutive sampling. Subjects will also be evaluated for the presence of LPR and autonomic nervous system dysfunction.

The results indicated that children with LPR were at a 5.59-fold increased risk of developing active safe type CSOM (OR: 5.59; 95% CI: 1.247–25.049; p = 0.025). Allergy (OR: 1.433; 95% CI: 0.343–5.981; p = 0.622) and adenoid hypertrophy (OR: 1.178; 95% CI: 0.584–2.378; p = 0.646) were not found to be statistically significant risk factors for active safe type CSOM. Additionally, autonomic nervous system dysfunction did not show statistical significance as a risk factor for LPR (OR: 1.086; 95% CI: 0.444–2.650; p = 0.856). LPR also did not appear to be a risk factor for Eustachian tube dysfunction (RR: 1.558; 95% CI: 0.594–4.087; p = 0.367). It can be concluded that LPR is a primary risk factor for active safe type CSOM in children. The presence of pepsin and the acidity level of the LPR refluxate in the middle ear may contribute to middle ear damage."