PURPOSE: The partners of cancer patients commonly provide the needs of cancer patients along cancer trajectory except for patients with gynecological cancer. In developing countries including Indonesia, who have strong family bonding, the family of cancer patients are involved more intensely in providing cancer care. This situation may bring the cancer patients' families experience the burden and decrease their quality of life. Therefore, assessing the family's supportive needs are as important as patient supportive needs. There are more gynecological cancer survivors in Indonesia; however, little is recognized about partners' supportive needs due to lack of validated assessment tools to measure it. This study aimed to translate, culturally adapted and test the validity and reliability of the CaSPUN questionnaire among partner of Indonesia gynecological cancer patients. DESIGN: First, the procedures of forward-backward translation and modification of the CaSPUN were conducted to ensure cultural adaptation. Second, using convenience sampling with 295 partners of gynecological cancer patients, we tested the construct validity and internal consistency of the CaSPUN-Indonesia Version (CaSPUN-I). We conducted Exploratory Factor Analysis to explore the factor structure of CaSPUN-I and Cronbach Alpha to confirm internal consistency reliability. RESULTS: The CaSPUN were modified to make more understandable and culturally appropriate in the Indonesian context. Five factors were extracted from EFA in the CaSPUN-I with factor loadings of items between 0.41 and 0.85. The Cronbach's alpha coefficient for the CaSPUN-I ranged from 0.96-0.97. CONCLUSION: The CaSPUN Indonesia version presents acceptable validity and reliability for assessing supportive care needs among families of Indonesian gynecological cancer patients. The CaSPUN-I can be used by healthcare providers to assess and design the supportive care program for family of Indonesia gynecological cancer patients.
Cancer Survivors ; Needs Assessment ; Cross-Cultural Comparison ; Indonesia

Purpose: Intestinal fibrosis is a common complication of inflammatory bowel diseases. However, the possible involvement of epithelial-mesenchymal transition (EMT) has been scarcely investigated. This systematic review aims to search through research papers that are focusing on messenger RNA (mRNA) and protein expression profile in EMT in fistula or in intestinal fibrosis. Methods: Electronic exploration was performed until April 24, 2019 through PubMed, Ovid, Science Direct, and Scopus databases with the terms of “fistula” OR “intestinal fibrosis” AND “epithelial-mesenchymal transition”. Two independent reviewers scrutinized the suitability of the title and abstract before examining the full text that met the inclusion criteria. For each study, the sample types that were used, methods for analysis, and genes expressed were identified. The list of genes was further analyzed using DAVID (Database for Annotation, Visualization, and Integrated Discovery) and KEGG (Kyoto Encyclopedia of Genes and Genomes) pathway. Results: There were 896 citations found; however, only 3 studies fulfilled the requirements. Among the EMT-related genes, 5 were upregulated genes at mRNA level while 6 were at protein level. However, only 2 downregulated genes were found at each mRNA and protein level. Of the 4 inflammation-related genes found, 3 genes were upregulated at mRNA level and 1 at protein level. These genes were confirmed to be involved in the development of inflammatory induced fibrosis and fistula through EMT. Results from quantitative real-time polymerase chain reaction analysis were consistent with the process of EMT, confirmed by the western blot protein analysis. Conclusion Many significant genes which are involved in the process of EMT in fistula and intestinal fibrosis have been identified. With high-end technology many more genes could be identified. These genes will be good molecular targets in the development of biomarkers for precision drug targeting in the future treatment of intestinal fibrosis and fistula.

Objective: To determine the effect of Plantago major (P. major) extract on the liver injury following acetaminophen (APAP) toxicity. Methods: The male Sprague Dawley rats (n = 38) were randomly divided into normal control (n = 6) and experiment (n = 32) groups. The latter was subdivided into four groups and induced with APAP (1. 000 mg/kg) per oral, followed by P. major extract and N-acetylcysteine orally to the respective groups for six days. Results: On the seventh day, the serum bilirubin, liver enzymes and tissue malondialdehyde were increased in APAP groups whereas the total protein in serum, tissue superoxide dismutase and glutathione levels were reduced. The plant extract treatment reduced the histological deteriorations such as aggregation of hepatocellular cords, formation of binucleated cells and vacuolisation of the cells with scanty cytoplasm. It also revealed significant reduction of malondialdehyde and increased level of superoxide dismutase and glutathione. The findings in the extract treated groups were comparable to the group treated with N-acetylcysteine. Conclusions: In conclusion, P. major can enhance innate antioxidant activity and ameliorate the APAP-induced liver injury.