Dany Hilmanto

Biopsychosocial model is a useful worldview for primary care or family doctors. However, it is often considered as impractical or too complicated. The objective of this study is to review the implementation of the biopsychosocial model in clinical practice, and its contributions to clinical outcomes. Hermeneutic circle literature review was conducted to provide experiential learning in an attempt to understand biopscyhosocial model, first developed by George Engel. Literature search started with review articles in Medline and Scopus as search engines. Citations from previous articles, editorials, and research articles were identified and interpreted in the context of the knowledge derived from all identified relevant articles. The progress of biopsychosocial model has been slow, and primary care doctors do not implement biopsychosocial medicine in their practice, while biomedical thinking and approach are still the dominant model. Biopsychosocial research addressed chronic illnesses and functional disorders as conditions in need for biopsychosocial model implementation. As payment scheme, clinical guidelines and clinical performance indicators are biomedically oriented, there is no incentive for primary care doctors to adopt biopsychosocial model in their practice. Workload and lack of competence in primary care may hinder the implementation of biopsychosocial model. Biopsychosocial model helps primary care doctors to understand interactions among biological and psychosocial components of illnesses to improve the dyadic relationship between clinicians and their patients and multidisciplinary approaches in patient care. Biopsychosocial model potentially improves clinical outcomes for chronic diseases and functional illnesses seen in primary care.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is responsible for coronavirus disease (COVID-19), potentially have severe kidney adverse effects. This organ expressed angiotensin-converting enzyme 2 (ACE2), the transmembrane protein which facilitate the entering of the virus into the cell. Therefore, early detection of the kidney manifestations of COVID-19 is crucial. Previous studies showed ACE2 role in various indications of this disease, especially in kidney effects. The MicroRNAs (miRNAs) in this organ affected ACE2 expression. Therefore, this review aims at summarizing the literature of a novel miRNA-based therapy and its potential applications in COVID-19-associated nephropathy. Furthermore, previous studies were analyzed for the kidney manifestations of COVID-19 and the miRNAs role that were published on the online databases, namely MEDLINE (PubMed) and Scopus. Several miRNAs, particularly miR-18 (which was upregulated in nephropathy), played a crucial role in ACE2 expression. Therefore, the antimiR-18 roles were summarized in various primate models that aided in developing the therapy for ACE2 related diseases.

Background . Given that hypertension in adulthood has its onset in childhood, it is not surprising that the prevalence of hypertension among adolescents has also increased in recent years. However, there are limited data on the prevalence of hypertension and also the new AAP guideline has not yet been applied to the Indonesian adolescent population. Thus, this study aimed to evaluate the prevalence of hypertension using the new AAP guideline and to assess the occurrence of its associated factors among Indonesian adolescents. Methods . This was a cross-sectional study conducted at twelve senior high schools in Palembang, South Sumatera, Indonesia, from June to December 2019. The study included adolescents aged 13 to 18 years old. Anthropometric measurements were obtained. Multiple logistic regression was used to assess the risk factors most associated with hypertension among adolescents, and then an equation model was created. The prevalence of hypertension was evaluated, together with several factors such as age group, sex, ethnicity, family history of hypertension, nutritional status, physical activity, perceived stress, sleep duration, nutritional intake, and smoking. Results . In total, 1200 adolescents aged 15.9 ± 0.99 years were evaluated. The prevalence of hypertension and elevated blood pressure among adolescents was 8% and 12.2%, respectively. There were significant associations between sex, family history of hypertension, hypertensive father, nutritional status, physical activity, perceived stress, and hypertension among Indonesian adolescents (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"><mml:mi>p</mml:mi><mml:mo>&lt;</mml:mo><mml:mn>0.05</mml:mn></mml:math>). Stress was the most powerful risk factor of hypertension with an odds ratio of 5.83 (95% confidence interval 2.91–11.6). Conclusions . Nowadays, the prevalence of hypertension among Indonesian adolescents is quite high. This may be caused by lifestyle or behavior changes among adolescents. Sex, family history of hypertension, nutritional status, physical activity, and perceived stress influenced the 27% hypertension prevalence rate among Indonesian adolescents, particularly in Palembang, South Sumatera. In order to decrease the prevalence of hypertension in adults, concern about lifestyle or behavior changes and hypertension among adolescents should be given.

Anemia in adolescent girls is still a problem in Indonesia. The impact of anemia is quite significant for adolescent health. This study aims to analyze related factors of anemia among adolescent girls, and the effect of anemia on the quality of life. The study was conducted in the Soreang District, West Java, Indonesia. This cross-sectional study involved 286 female students (15−19 years). A 24-h recall questionnaire was used to collect the nutrient intake. We use the WHOQOL-BREF to analyze the quality of life. The study assessed height, weight, body mass index (BMI), mid-upper arm circumference (MUAC), and a capillary blood sample to determine hemoglobin levels. Bivariate and multiple logistic regression tests were measured to find the factors most influencing anemia. The prevalence of anemia was 14.3%. Related factors of anemia in this study were: duration of blood show per menses, iron consumption, weight, height, and MUAC. From bivariate analyses, anemia influenced the social relationships domain with p < 0.05. Multivariate logistic regression showed that the most influencing factors for anemia were MUAC and duration of blood per menses. Anemia impacted the social relationships domain. In this study, the two main factors that affected anemia were MUAC and duration of blood each menstrual cycle.

Background: Iron deficiency anemia is a common problem among adolescent girls and women, with significant consequences on personal health. One of the causes of iron deficiency anemia is inadequate nutritional intake. This study explores iron-deficiency anemia and associated factors among adolescent girls and women in a rural area of Jatinangor, Indonesia. Methods: A cross-sectional study was conducted with 95 adolescent girls and 85 women between April and November 2018. Cluster random sampling was used to select the participants from seven villages in the Jatinangor district. After obtaining informed consent, we collected sociodemographic data, menstrual histories, and related data, including nutritional intake using 24-hour dietary recall. Anthropometrics were gathered to determine the body mass Index (BMI), and venous blood samples were analyzed for complete blood count and hemoglobin levels. Descriptive statistics followed by bivariate and multivariable logistic regression were used to identify anemia-associated factors. Results: The prevalence of iron deficiency anemia among the girls was 21.1% and 9.4% among women, with an average hemoglobin level in adolescents of 10.75 g/dL (± 0.79) and in adults 11.20 g/dL (± 0.61), whereas MCV was 74.49±8.22 fL in adolescents and 7.61±8.62 fL in adults. The majority of our samples were not stunted in growth and were also within a normal weight range. Multivariate logistic regression analysis showed that protein intake (OR=0.25; 95% CI 0.11-0.58) was a positively associated factor with anemia. Conclusion: The prevalence of iron-deficiency anemia in this study represents a mild public health problem in the study sample. Based on the hemoglobin level, anemia, can be classified as moderate in adolescents and mild in adults. Low levels of MCH indicate iron-deficiency anemia. Sufficient protein intake did not prevent anemia due to macronutrient and micronutrient intake.