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"This comprehensive guide delivers informed hope along with effective tools for reclaiming your vitality in the midst of cancer treatment, healing, and recovery.When you or a loved one is faced with a cancer diagnosis, the need for accurate and trusted medical information becomes urgent. Naturopathic physician Lise N. Alschuler and medical journalist Karolyn A. Gazella present an overview of what cancer is, its causes and preventative strategies, an in-depth approach to integrative treatment options, descriptions of key body functions, and discussions of more than twenty specific cancers. The Definitive Guide to Cancer, now in its third edition, encourages you to take an integrative approach that embraces both alternative and conventional therapies across the spectrum of cancer prevention, treatment, and healing."

"Research has consistently documented the significance of severe life events for onset of major depression. Theory, however, suggests other forms of stress are relevant for depression's recurrence. Nonsevere life events were tested in relation to depression for 126 patients with recurrent depression in a 3-year randomized maintenance protocol. Life stress was assessed every 12 weeks and rated along dimensions of severity, focus, and independence. A significant interaction between specific types of nonsevere life events and medication was found. For medicated patients, subject-focused independent nonsevere life events predicted recurrence; for unmedicated patients, these events predicted fewer recurrences. Other nonsevere life events did not predict recurrence. The findings underscore the potential importance of specific stressors for triggering recurrences of depression."

"ABSTRAK Latar Belakang: EORTC menekankan pentingnya menilai kualitas hidup pasien kanker. Saat ini, di Indonesia, belum ada kuesioner yang reliabel dan valid untuk menilai kualitas hidup pasien kanker payudara secara akurat. Tujuan: membuktikan bahwa EORTC-QLQ-BR23 merupakan kuesioner yang reliabel dan valid digunakan di Indonesia Metode: Penelitian dimulai dengan menerjemahkan EORTC-QLQ-BR23 ke dalam bahasa Indonesia dan kemudian diujicobakan pada 10 responden. Setelah itu, EORTC QLQ-BR23 hasil terjemahan digunakan pada penelitian utama. Test-retest dinilai dengan Intraclass Correlation Coeficient (ICC). Konsistensi internal dinilai dengan cronbach alpha. Construct validity dinilai dengan multi-trait scaling analysis. Validitas kriteria dinilai dengan melihat korelasi antara domain EORTC-QLQ-C30 dan EORTC-QLQ-BR23 dengan SF36. Hasil: Telah dilakukan pengambilan data terhadap 100 pasien kanker payudara dari September ? Oktober 2015. Nilai ICC (interval 1 jam) pada semua domain sangat baik (ICC > 0,8). Nilai cronbach alpha > 0,7 pada hampir semua domain. Multi-trait scaling analysis menunjukkan korelasi cukup tinggi antara skor pertanyaan dengan skor domainnya sendiri. Uji validitas kriteria, didapatkan 19 korelasi dengan r > 0,3 antara domain EORTC-QLQ-C30 dan EORTC-QLQ-BR23 dengan SF36. Simpulan: EORTC-QLQ-BR23 merupakan kuesioner yang reliabel dan valid digunakan di Indonesia.ABSTRACT Background: EORTC emphasize the importance of assessing quality of life in cancer patients. In Indonesia, there has been no reliable and valid questionnaire to assess quality of life of breast cancer patients accurately. Objective: To prove that EORTC-QLQ-BR23 is reliable and valid questionnaire used in Indonesia. Methods: Study began with the EORTC-QLQ-BR23 translated into Indonesian and then tested on 10 respondents. Indonesian version of EORTC-QLQ-BR23 is used in main study. Test-retest was assessed with intraclass correlation coeficient (ICC). Internal consistency was assessed by Cronbach alpha. Construct validity was assessed by multi-trait scaling analysis. Criteria validity assessed by looking at correlation between EORTC-QLQ-C30 and EORTC-QLQ-BR23 with SF36. Results: Data collection were done on 100 breast cancer patients from September to October 2015. ICC value (1 hour interval) in all domains of EORTC-QLQ-BR23 is very good (ICC> 0.8). Cronbach alpha values >0.7 in almost all EORTC-QLQ-BR23 domains. Multi-trait scaling analysis showed a high correlation between scores of questions with a score of his own domain. Criteria validity test, obtained 19 correlation with r>0,3 between domains EORTC-QLQ-C30 and EORTC-QLQ-BR23 with SF36. Conclusion: EORTC-QLQ-BR23 is a reliable and valid questionnaire used in Indonesia.;Background: EORTC emphasize the importance of assessing quality of life in cancer patients. In Indonesia, there has been no reliable and valid questionnaire to assess quality of life of breast cancer patients accurately. Objective: To prove that EORTC-QLQ-BR23 is reliable and valid questionnaire used in Indonesia. Methods: Study began with the EORTC-QLQ-BR23 translated into Indonesian and then tested on 10 respondents. Indonesian version of EORTC-QLQ-BR23 is used in main study. Test-retest was assessed with intraclass correlation coeficient (ICC). Internal consistency was assessed by Cronbach alpha. Construct validity was assessed by multi-trait scaling analysis. Criteria validity assessed by looking at correlation between EORTC-QLQ-C30 and EORTC-QLQ-BR23 with SF36. Results: Data collection were done on 100 breast cancer patients from September to October 2015. ICC value (1 hour interval) in all domains of EORTC-QLQ-BR23 is very good (ICC> 0.8). Cronbach alpha values >0.7 in almost all EORTC-QLQ-BR23 domains. Multi-trait scaling analysis showed a high correlation between scores of questions with a score of his own domain. Criteria validity test, obtained 19 correlation with r>0,3 between domains EORTC-QLQ-C30 and EORTC-QLQ-BR23 with SF36. Conclusion: EORTC-QLQ-BR23 is a reliable and valid questionnaire used in Indonesia."

"Permasalahan kesehatan yang perlu penanganan serius di Indonesia adalah tingginya angka kasus stunting. Stunting terjadi hampir diseluruh wilayah Indonesia satu dari tiga baduta dan balita mengalami stunting, prevalensi stunting berdasarkan Studi Status Gizi Indonesia (SSGI) tahun 2022 sebesar 21,6%. Target pemerintah Kota Jambi untuk menurungkan prevalensi sebesar 14% ditahun 2024 hal ini termuat secara jelas dalam Peraturan Presiden nomor 18 tahun 2020 tentang RPJMN 2020-2024. Dampak stunting pada anak-anak menyebabkan hilangnya PDB hingga mencapai 300 triliun rupiah setiap tahunnya, dengan implikasi serius terhadap aspek psikososial dan kesehatan mental anak. Stunting adalah gangguan pertumbuhan dan perkembangan anak akibat kekurangan gizi kronis dan infeksi berulang, yang ditandai dengan pendek atau sangat pendek berdasarkan panjang / tinggi badan menurut usia yang kurang dari -2 standar deviasi (SD) pada kurva pertumbuhan WHO. Prevalensi stunting Provinsi Jambi berdasarkan tarikan data EPPGBM berjumlah 18% pada Tahun 2022. Data tertinggi stunting pada Agustus 2023 terdapat di Puskesmas Tanjung Pinang Kota Jambi sebanyak 67 anak yang mengalami peningkatan dari tahun 2022 sebanyak 23 anak. Penelitian ini bertujuan untuk menganalisis studi kualitatif program pencegahan stunting pada pelaksanaan intervensi gizi spesifik integratif di wilayah kerja Puskesmas Tanjung Pinang Kota Jambi Tahun 2023. Penelitian kualitatif ini menggunakan data primer yang berasal dari wawancara mendalam dan data sekunder yang berasal dari telaah dokumen. Hasil penelitian menunjukkan belum optimalnya perencanaan dan penganggaran, kerjasama lintas sektoral serta pembagian kewenangan pada jajararan pemerintahan yang dapat menjadi potensi penghambat pada percepatan penurunan stunting di wilayah kerja Kecamatan Jambi Timur terutama pada kualitas pelayanan intervensi gizi spesifik integratif stunting yang dilaksanakan di puskesmas Tanjung Pinang. Pada komponen input, perencanaan dan pengganggaran serta kerjasama lintas sektor dan pembagian kewenangan belum di laksanakan dengan implementasi langsung terkait integrasi stunting . Pada komponen proses, yaitu pelayanan yang di lakukan terhadap sasaran prioritas sudah di lakukan tetapi pemantauan dan evaluasi pemberian TTD ibu hamil belum dilakukan berkala dan pendistribusia MT serta TTD belum dibuat jadwal secara tertulis. Pada komponen output, kualitas peningkatan indikator intervensi gizi spesifik terutama pada capaian cakupan Ibu memberikan asi eksklusif dan remaja putri mendapatkan TTD serta Ibu hamil mendapat TTD masih belum mencapai target. Peran dari keterlibatan lintas sektor serta edukasi dari tenaga kesehatan untuk menggiatkan para ibu guna memberikan asi eksklusif serta para remaja putri dan Ibu Hamil untuk rutin mengkonsumsi tablet tambah darah perlu ditingkatkan dan didukung penuh.

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A health problem that needs serious treatment in Indonesia is the high number of stunting cases. Stunting occurs in almost all regions of Indonesia, one in three toddlers and toddlers are stunted, the prevalence of stunting based on the 2022 Indonesian Nutrition Status Study (SSGI) is 21.6%. The Jambi City government's target to reduce prevalence by 14% by 2024 is clearly stated in Presidential Regulation number 18 of 2020 concerning RPJMN 2020-2024. The impact of stunting on children causes GDP losses of up to 300 trillion rupiah every year, with serious implications for psychosocial aspects and children's mental health. Stunting is a growth and development disorder in children due to chronic malnutrition and recurrent infections, which is characterized by being short or very short based on length/height for age which is less than -2 standard deviation (SD) on the WHO growth curve. The prevalence of stunting in Jambi Province based on EPPGBM data is 18% in 2022. The highest stunting data in August 2023 was at the Tanjung Pinang Community Health Center, Jambi City, with 67 children, which had increased from 2022 with 23 children. This research aims to analyze a qualitative study of the stunting prevention program in the implementation of specific integrative nutritional interventions in the work area of ​​the Tanjung Pinang Community Health Center, Jambi City in 2023. This qualitative research uses primary data originating from in-depth interviews and secondary data originating from document review. The results of the research show that planning and budgeting, cross-sectoral cooperation and the division of authority within government levels are not yet optimal, which could be a potential obstacle to accelerating stunting reduction in the East Jambi District work area, especially in the quality of stunting-specific integrative nutritional intervention services implemented at the Tanjung Pinang health center. In the input component, planning and budgeting as well as cross-sector collaboration and division of authority have not been carried out with direct implementation regarding stunting integration. In the process component, namely the services provided to priority targets have been carried out but monitoring and evaluation of the provision of TTD to pregnant women has not been carried out regularly and the distribution of MT and TTD has not yet been made into a written schedule. In the output component, the quality of improvement in specific nutritional intervention indicators, especially in achieving coverage of mothers providing exclusive breastfeeding and adolescent girls receiving TTD and pregnant women receiving TTD, has still not reached the target. The role of cross-sector involvement and education from health workers to encourage mothers to provide exclusive breastfeeding as well as young women and pregnant women to regularly consume blood supplement tablets needs to be increased and fully supported.

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"Latar Belakang: Meskipun berbagai kemajuan pengobatan dicapai selama lebih dari satu dekade terakhir, secara keseluruhan prognosis karsinoma sel hati tetap buruk. Efek samping terapi serta progresifitas penyakit itu sendiri sangat mempengaruhi kualitas hidup pasien. Selain kesembuhan dan survival rate, kualitas hidup menjadi poin akhir penting dalam pengobatan kanker. Kualitas hidup pada penderita karsinoma sel hati penting untuk diteliti, karena merupakan faktor prognostik penting dari survival time, selain dapat juga mengevaluasi keuntungan dan kerugian dari modalitas terapi yang dipilih. Sampai saat ini belum ada kuesioner yang andal dan sahih untuk menilai kualitas hidup pasien karsinoma sel hati secara akurat di Indonesia. Penelitian ini bertujuan untuk mendapatkan kuesioner European Organization for Research and Treatment of Cancer Quality of Life Questionnaire for Hepatocellular Carcinoma-18 (EORTC QLQ-HCC18) yang andal dan sahih untuk digunakan di Indonesia.Metode: Penelitian ini adalah studi potong lintang. Penelitian diawali dengan menerjemahkan EORTC QLQ-HCC18 ke dalam bahasa Indonesia dan kemudian diujicobakan pada 10 responden. Setelah itu, EORTC QLQ-HCC18 hasil terjemahan digunakan pada penelitian utama dengan jumlah sampel yang lebih besar. Keandalan dinilai dengan pendekatan tes ulang dan konsistensi internal. Tes ulang dinilai dengan intraclass correlation coefficient (ICC). Konsistensi internal dinilai dengan Cronbach Alpha. Kesahihan konstruksi dinilai dengan multi-trait scaling analysis. Kesahihan kriteria dinilai dengan melihat korelasi antara domain kuesioner EORTC QLQ-HCC18 dengan Short Form 36 (SF36).Hasil: Pengambilan data dilakukan terhadap 65 pasien karsinoma sel hati yang berobat ke Poli Hepatologi maupun yang sedang dirawat di RSUPN Cipto Mangunkusumo selama Oktober 2015 ? Februari 2016. Nilai ICC (interval 1 jam) pada semua domain EORTC QLQ-HCC18 sangat baik (ICC > 0,8), kecuali domain ikterus yang termasuk dalam kategori baik (ICC 0,61-0,8). Nilai Cronbach Alpha > 0,7 pada separuh jumlah domain EORTC QLQ-HCC18 kecuali domain ikterus (0,137), nyeri (0,474), dan citra tubuh (0,599). Sedangkan nilai Cronbach Alpha yang diperoleh dari penggabungan seluruh domain tetap baik, yaitu 0,897. Multi-trait scaling analysis menunjukkan korelasi cukup tinggi antara skor butir pertanyaan dengan skor domainnya sendiri. Sedangkan hubungan butir pertanyaan dengan domain yang berbeda selalu mempunyai korelasi yang lebih rendah dibandingkan dengan domainnya sendiri. Pada uji kesahihan kriteria, didapatkan 42 korelasi (dari total 64 korelasi) dengan r ≥ 0,3 dan p < 0,05 antara domain EORTC QLQ-HCC18 dengan SF36.Simpulan: Kuesioner EORTC QLQ-HCC18 merupakan alat ukur yang andal dan sahih untuk menilai kualitas hidup pasien karsinoma sel hati di Indonesia.

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Background: Despite various therapeutic progress has been achieved over the past decade, the overall prognosis of hepatocellular carcinoma remains poor. Each therapy undertaken certainly has side effects. Adverse effect of treatment and the progression of the disease itself greatly affect the patient?s quality of life. In addition to recovery and survival rate, quality of life becomes extra important end point in cancer treatment. Quality of life in hepatocellular carcinoma is important to investigate, because quality of life has become an important prognostic factor of survival time, whilst quality of life can also evaluate the cost and benefit of chosen therapeutic modalities. Currently there is no specific questionnaire that can assess the quality of life of hepatocellular carcinoma patients accurately in Indonesia. This study aims to get a reliable and valid EORTC QLQ-HCC18 questionnaire to assess the quality of life of patients with hepatocellular carcinoma in Indonesia.Methods: This is a cross-sectional study. The study began by translating the EORTC QLQ-HCC18 into Indonesian and then tested on 10 respondents. After that, the Indonesian version of EORTC QLQ-HCC18 is used in the main study with a larger sample size. The questionnaire reliability was assessed with test-retest and internal consistency approach. Test-retest was assessed with intraclass correlation coeficient (ICC). Internal consistency was assessed by Cronbach alpha. Construct validity was assessed by multi-trait scaling analysis. The criteria validity assessed by looking at the correlation between domains of EORTC QLQ-HCC18 with Short Form 36 (SF36).Results: Data was collected from 65 hepatocellular carcinoma patients who came to Hepatology Polyclinic or were hospitalized at Cipto Mangunkusumo National General Hospital from October 2015 to February 2016. ICC value (1 hour interval) in all domains of EORTC QLQ-HCC18 is very good (ICC> 0.8), except icterus domain which categorized as good value (ICC 0,61-0,8). Cronbach alpha values > 0.7 obtained in almost half of domains of EORTC QLQ-HCC18, except icterus (0,137), pain (0,474), dan body image domain (0,599). Whereas the Cronbach Alpha obtained from merging the entire domains was still good (0,897). Multi-trait scaling analysis showed a fairly high correlation between the scores of the questions with a score of his own domain. While the relationship of the questions with different domains always have a lower correlation than the domain itself. In criteria validity test, obtained 33 correlations with r ≥ 0,4 and p < 0,05 between domains of EORTC QLQ-HCC18 with SF36.Conclusion: EORTC QLQ-HCC18 is a reliable and valid instrument for assessing quality of life of hepatocellular carcinoma patients in Indonesia.

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