Most preterm infants exhibit atypical and immature feeding skills. Even though preterm infants have fulfilled the oral feeding readiness criteria, they still do not have optimal oral feeding ability. This study aimed to determine various factors affecting oral feeding ability in Indonesian preterm infants who have fulfilled oral feeding readiness criteria but still have not been able to feed orally. A cross-sectional study included 120 preterm infants admitted to five tertiary hospitals in Jakarta, Indonesia. Participants were preterm infants born at 28–34 weeks gestational age who had fulfilled the oral feeding readiness as the inclusion criteria: (1) stable cardiorespiratory status, (2) have achieved full enteral feeding via orogastric tube (OGT) 120 mL/kg/day without vomiting or bloating, and (3) strong and rhythmic non-nutritive sucking (NNS) through objective measurement. Infants’ oral feeding ability and various factors that were assumed to affect oral feeding ability, including physiological flexion postural tone, physiological stability, rooting reflex, self-regulation, behavioral state, and level of morbidity were evaluated. Chi-square and multivariate analysis with Poisson regression were performed. Results indicated that postural tone, rooting reflex, physiological stability, self-regulation, behavioral state, and level of morbidity were significantly related to oral feeding ability in preterm infants. The most influencing factors were self-regulation with a prevalence ratio (PR) of 1.96 (1.16–3.34; CI 95%) and p = 0.012, followed by postural tone, high morbidity, and behavioral state (PR 1.91; 1.59; 1.56; CI 95%, respectively). In conclusion, despite meeting the oral feeding readiness criteria, most preterm infants were still not able to feed orally. There are other factors affecting oral feeding ability in Indonesian preterm infants.

Telerehabilitation has the potential to help expand the reach of rehabilitation intervention. An online questionnaire-based Delphi method set out to develop a telerehabilitation guideline for patients in Indonesia with Long COVID. A Delphi panel comprised of 24 experts was selected from all relevant disciplines. Over two rounds of Delphi testing, panelists gave opinions and indicated their level of agreement with each recommendation. Key elements of consensus for a telerehabilitation guideline for patients with Long COVID includes: the benefit of telerehabilitation, types of rehabilitation intervention needed, methods of intervention, criteria for home-based self-exercise training, set-up of rehabilitation prescription, exercise monitoring, evaluation of rehabilitation intervention and duration of rehabilitation intervention. Further research is needed to determine the feasibility and effectiveness of this guideline.

Osteoarthritis (OA) lutut merupakan penyebab utama disabilitas fisik pada lansia yang menyebabkan keterbatasan dalam kehidupan sosial dan seringkali mempengaruhi kesehatan mental. Total Knee Arthroplasty (TKA) atau Total Knee Replacement (TKR) merupakan tatalaksana OA lutut stadium akhir yang tidak menunjukkan perbaikan pasca tatalaksana non-operatif. Akan tetapi, ditemukan sekitar 10- 67 % pasien mengalami nyeri kronis atau persisten setelah TKA. Banyak faktor yang dapat memprediksi terjadinya nyeri kronis pasca TKA, salah satunya adalah faktor psikologis seperti depresi. Penelitian ini bertujuan untuk mengetahui prognosis terjadinya nyeri kronis pada pasien lansia pasca operasi TKA yang mengalami depresi sebelum operasi. Pencarian artikel dilakukan di tiga basis data, yaitu PubMed®, Cochrane® dan Embase®. Menggunakan Medical Subject Heading (MeSH) terms, title/abstract, text word, dan Boolean (“OR” dan “AND”). Studi yang ditelaah adalah systematic review, meta-analysis, dan cohort study, yang dinilai menggunakan Centre for Evidence-Based Medicine (Oxford). Pencarian dilakukan pada bulan Maret 2023. Terdapat 3 artikel yang dianalisis. Depresi pre-operasi berpengaruh signifikan terhadap nyeri derajat ringan sedang yang dirasakan pada 2 tahun pasca operasi TKA primer dengan adjusted OR 1,5 ([95% CI 1,2-2,0], p<0,01) dan 5 tahun pasca operasi TKA primer dengan adjusted OR 2,0 ([95% CI 1,4-2,9], p<0,01). Depresi sebelum operasi merupakan faktor prediksi yang sangat signifikan dan berpengaruh kuat terhadap kemungkinan terjadinya nyeri kronis secara objektif dan subjektif pada pasien lansia pasca operasi TKA.

Indonesia ranks third in terms of countries with the highest number of leprosy in the world. This fact hasn't changed since 20 years ago. This shows the magnitude of leprosy management problems, both at the world level and national level. These problems range from the problem of finding new cases, continuity of the provision of various drug regimens, and control of the spread. In addition to problems related to the detection and handling of new cases, there are also problems in leprosy survivors. Survivors generally have disabilities due to the disease. The disability can continue to be aggravated over time, even though leprosy itself has healed long since. These disabilities vary from numbness, paralysis, shortened and claw-like fingers on the hands and feet, wounds resulting in amputations of the nose, ears, fingers and limbs. Such problems require a complete and continues management. Meanwhile, the management of leprosy, both in patients and survivors, has challenges both in terms of medical, policy, financing, and culture. Not to mention the challenges related to low socialistism, not many Indonesians know the problem of leprosy, especially knowing the magnitude of the problem. Pandemic conditions make things worse. This case report will explain the journey of leprosy survivor who has been amputated and has rehabilitation related to the maintenance and replacement of leg prosthetic in pandemic situation. It will describe the stigma, medical, and socioeconomic challenges that he has to go through. This case report is expected to be an inspiration in improving public, academics, policy makers, and stakeholder awareness, related to leprosy handling problems in Indonesia, both problems for patient and survivors. Thus, it is ultimately expected to reduce the level of disability, promote equal rights for people with disabilities, and support the realization of leprosy elimination nationally and internationally. Indonesia adalah negara dengan prevalensi kusta terbanyak No.3 di dunia. Fakta tersebut tidak berubah sejak 20 tahun yang lalu. Hal tersebut menunjukkan besarnya masalah penanganan kusta, baik di tingkat dunia dan di tingkat nasional. Masalah tersebut mencakup mulai dari masalah penemuan kasus baru, kontinuitas penyediaan berbagai regimen obat, hingga pengendalian penyebaran Kusta. Selain masalah terkait deteksi dan penanganan kasus baru, terdapat pula masalah pada para penyintas kusta. Para penyintas umumnya memiliki disabilitas akibat penyakit tersebut. Disabilitas tersebut dapat terus memberat dari waktu ke waktu, walaupun penyakit kustanya sendiri telah lama sembuh. Disabilitas tersebut bervariasi, mulai dari mati rasa, kelumpuhan, jari-jari yang memendek dan berbentuk seperti cakar pada tangan dan kaki, hingga luka yang terus menerus timbul lalu mengakibatkan amputasi pada hidung, telinga, jari dan tungkai. Masalah seperti ini memerlukan penanganan yang paripurna dan berkelanjutan. Sementara penanganan kusta secara kesuluruhan, baik pada penyandang ataupun penyintas, menghadapi tantangan baik dari segi medis, kebijakan, pembiayaan, dan budaya. Belum lagi tantangan terkait rendahnya sosialisai, tidak banyak masyarakat Indonesia yang mengetahui masalah kusta, terlebih mengetahui besaran masalahnya. Kondisi pandemi pun memperburuk segalanya. Laporan kasus ini akan menjelaskan tantangan stigma, masalah medis, serta sosial ekonomi yang dihadapi oleh penyintas kusta yang telah mengalami amputasi selama menjalani rehabilitasi terkait pemeliharaan dan penggantian kaki palsu di masa pandemi. Laporan kasus ini diharapkan dapat menjadi inspirasi bagi penanganan dan peningkatan kepedulian warga masyarakat, akademisi, pemangku kebijakan, serta unsur komunitas terkait terhadap masalah penanganan kusta di Indonesia, baik masalah pada penyandang ataupun penyintas. Dengan demikian, pada akhirnya diharapkan dapat mengurangi tingkat disabilitas, mempromosikan persamaan hak bagi kelompok masyarakat penyandang disabilitas, serta mendukung terwujudnya eliminasi kusta secara nasional dan internasional.

Virtual reality (VR) is a technology that allows users to do interactive activities in virtual circumstances. Rehabilitation using VR has shown effective result in treating cognitive impairment in elderly. VR offers a high level of flexibility and control over the user, enabling the user to perform intensive training according to their ability, keeping it enjoyable and compelling. Despite this fact, geriatric patients also face challenges in integrating technology into their daily activities, especially in developing country. Thus, Universitas Indonesia creating VR exergame software (VRE) which was named VRAGMENT. This study aimed to know the correlation of cognitive with VR satisfaction using VRAGMENT in elderly patients. This was a cross-sectional study, conducted on May until July 2023. Cognitive function was measured using Montreal Cognitive Assessment Indonesian Version (MoCA-Ina) and VR satisfaction was measured using Technology Acceptance Model (TAM). We use Meta Oculus VR as the hardware for VRAGMENT program. We recruited 80 elderly at the outpatient setting and 32 elderly at the inpatient setting, with MoCA-Ina range 8-30. All subjects enjoy VRAGMENT session. Subjects with higher cognitive levels have higher satisfaction than those with lower cognitive levels (r = 0.434, P<.05). There is a correlation between cognitive function that was measured using MoCA-Ina and brief VR satisfaction questionnaire. VRAGMENT protocols need to be adapted so could facilitate cognitive impairment and increase elderly satisfaction with this technology. Keywords: Elderly, Virtual Reality, Cognitive

Introduction: Virtual Reality (VR) could improve mental and physical condition. However, limited studies have been conducted on VR utilization for the elderly in acute wards. This study aimed to evaluate the acceptability and tolerability of a VR Prototype called VRAGMENT in the acute geriatric ward, as well as the acceptance correlation with cognitive function. Methods: In this cross-sectional study, thirty-two subjects were recruited consecutively. Their satisfaction and complaints during and after a single VRAGMENT session were recorded using a questionnaire that elaborates the Technology Acceptance Model. VRAGMENT is a VR game programmed based on Instrumental Activities of Daily Living, designed by Universitas Indonesia. Result: No falls or near falls were reported. No subject reported nausea, boredom, sleepiness, or oculomotor impairments such as dry or red eye, eye strain, blur, or difficulty focusing. Few subjects complained of general discomfort (19%), fatigue (6%), headache (9%), and dizziness (16%). All subjects declared that they were satisfied, enjoyed, and impressed. Most of them (97%) stated that VRAGMENT met their expectations and needs, and would like to recommend it to others. The overall acceptance and perceived ease of learning were significantly correlated with cognitive function. Conclusion: This study proved that despite their age, cognitive impairment, and acute clinical condition, most subjects could accept and tolerate VRAGMENT sessions. This could be achieved through since VRAGMENT specifically designed for the elderly with cognitive impairment, as well as game protocol adaptation. Following study about the effect on patient outcomes needs to be conducted.