Objectives: Recovery from drug addiction often poses challenges for the recovering person. The coping mechanisms employed by these individuals to resist temptations and manage stress play a key role in the healing process. This study was conducted to explore the coping strategies or techniques that individuals with addiction use to handle stress and temptation while undergoing treatment. Methods: A qualitative meta-synthesis approach was utilized to critically evaluate relevant qualitative research. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines were used for article selection, with these standards applied to 4 academic databases: Scopus, PubMed, ProQuest, and CINAHL. The present review included studies published between 2014 and 2023, selected based on pre-established inclusion criteria. The quality of the studies was assessed using the Critical Appraisal Skills Programme Qualitative Studies Checklist. This review was registered with the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42024497789. Results: The analysis of 13 qualifying qualitative articles revealed 5 major themes illustrating the coping mechanisms employed in the pursuit of recovery by individuals who use drugs. These themes include seeking social support, as well as psychological coping strategies, spiritual experiences, professional interventions, and the enhancement of awareness. Conclusions Among individuals with drug addiction, coping mechanisms are crucial for resisting stress and temptations throughout the recovery process. Healthcare professionals, as medical specialists, can establish more thorough and effective plans to support these patients on their path to recovery.

Biomechanical abnormalities of pronated feet accompanied by functional leg length disparity may increase the risk of skeletal muscle injury. Objective of the study is to prove that correction of pronated feet by the foot orthoses will reduce the creatine kinase-MM (CK-MM) concentrations as the muscle injury indicator. The design study was double blind randomized clinical trials with control. Research subjects were divided into two groups, group 1 used the foot orthoses while group 2 did not used the foot orthoses. The whole subject examined the concentrations of the CK-MM enzyme before, and 24–72 hours after the walking test. The walking test was conducted 15 minutes with maximum speed. The concentration of the CK-MM enzyme before walking test on treatment group was 70.07±15.33 International Unit (IU), similar with the control group was 69.85±17.03 IU (P=0.971). The increased in CK-MM enzyme concentrations 45 hours after the walking test was lower in the treatment group (7.8±9 IU) than the control group (22.0±11.5 IU) (P=0.001). The CK-MM enzyme concentrations continued to decline in the treatment group after the second walking test (77.21±17.47 IU), and after the third walking test (69.86±11.88 IU) (P=0.018). The foot orthoses for correcting the pronated feet on the young women with biomechanical abnormalities is able to reduce the degree of the skeletal muscle injury after walking activity.
Creatine ; Female ; Foot Orthoses ; Foot* ; Humans ; Leg ; Muscle, Skeletal* ; Research Subjects ; Walking

OBJECTIVE: This study aimed to examine the effect of vitrification on apoptosis and survival in human preantral follicles after thawing.METHODS: This experimental study was conducted at an acute tertiary care hospital from March 2012 to April 2013. Ovaries were sliced into 5×5×1-mm pieces and divided into the following three groups: preantral follicle isolation, ovarian tissue vitrification-warming followed by follicle isolation, and immunohistochemistry of fresh ovarian tissue. For statistical analyses, the Student t-test, chi-square test, Kruskal-Wallis test, and Kaplan-Meier survival analysis were used.RESULTS: A total of 161 preantral follicles (70% secondary) were collected from ovarian cortex tissue of six women between 30 and 37 years of age who underwent oophorectomy due to cervical cancer or breast cancer. There were no significant differences in the follicular morphology of fresh preantral follicles and vitrified follicles after thawing. The mean Fas ligand (FasL) mRNA expression level was 0.43±0.20 (relative to β-actin) in fresh preantral follicles versus 0.51±0.20 in vitrified follicles (p=0.22). The mean caspase-3 mRNA expression level in fresh preantral follicles was 0.56±0.49 vs. 0.27±0.21 in vitrified follicles (p=0.233). One vitrified-thawed secondary follicle grew and developed to an antral follicle within 6 days of culture.CONCLUSION: Vitrification did not affect preantral follicle morphology or mRNA expression of the apoptosis markers FasL and caspase-3. Further studies are required to establish whether vitrification affects the outcomes of in vitro culture and the maturation of preantral follicles.
Apoptosis ; Breast Neoplasms ; Caspase 3 ; Fas Ligand Protein ; Female ; Humans ; Immunohistochemistry ; In Vitro Techniques ; Ovariectomy ; Ovary ; RNA, Messenger ; Tertiary Healthcare ; Uterine Cervical Neoplasms ; Vitrification

Objectives: One of the most widely used pesticides today is chlorpyrifos (CPF). Cytochrome P450 (CYP)2B6, the most prominent catalyst in CPF bioactivation, is highly polymorphic. The objective of our study was to evaluate the role of CYP2B6*6, which contains both 516G>T and 785A>G polymorphisms, in CPF toxicity, as represented by the concentration of 3,5,6-trichloro-2-pyridinol (TCPy), among vegetable farmers in Central Java, Indonesia, where CPF has been commonly used. Methods: A cross-sectional study was conducted among 132 vegetable farmers. Individual socio-demographic and occupational characteristics, as determinants of TCPy levels, were obtained using a structured interviewer-administered questionnaire and subsequently used to estimate the cumulative exposure level (CEL). TCPy levels were detected with liquid chromatography-mass spectrometry. CYP2B6*6 gene polymorphisms were analyzed using a TaqMan® SNP Genotyping Assay and Sanger sequencing. Linear regression analysis was performed to analyze the association between TCPy, as a biomarker of CPF exposure, and its determinants. Results: The prevalence of CYP2B6*6 polymorphisms was 31% for *1/*1, 51% for *1/*6, and 18% for *6/*6. TCPy concentrations were higher among participants with CYP2B6*1/*1 than among those with *1/*6 or *6/*6 genotypes. CYP2B6*6 gene polymorphisms, smoking, CEL, body mass index, and spraying time were retained in the final linear regression model as determinants of TCPy. Conclusions The results suggest that CYP2B6*6 gene polymorphisms may play an important role in influencing susceptibility to CPF exposure. CYP2B6*6 gene polymorphisms together with CEL, smoking habits, body mass index, and spraying time were the determinants of urinary TCPy concentrations, as a biomarker of CPF toxicity.

Occupational health and nutrition are closely related. Nutrition in the workplace plays an essential role in supporting workers' health through a balanced nutrition approach. Reciprocally Occupational health is an approach to solving nutritional problems in workers, which in turn impacts the nutrition and health of families and communities. The workplace-based nutrition promotion is one of the pillars of the occupational health approach to solving health problems among workers. The workers' health related to nutrition is still a big challenge; on the other hand, the workplace is a potential setting for solving workers' and community health and nutrition problems. Currently, the Southeast Asian Region has been facing multiple burdens of the workers/productive age nutrition problem. The problem of nutritional deficiency, especially iron and other nutrients deficiency anemia dominate in women workers, especially pregnant women. The prevalence of anemia in working women is high in some Asian countries such as Bangladesh, Cambodia, India, Indonesia, Maldives, Myanmar, Nepal, and Timor Leste. The prevalence of anemia in women of productive age in these countries ranges from 22.7% to more than 50%.1 Meanwhile, other nutritional deficiencies such as folic acid and zinc also add to the magnitude of the calorie and protein deficiency problem in this population. Along with the problem of nutritional deficiency, Southeast Asian countries are also facing obesity and the risk of non-communicable diseases related to diets, such as hypertension and cardiovascular disease. It was noted that the prevalence of obesity in workers reached 49.8% among males and 50.2% among females.2 Work and work environment are significant risk factors for obesity among workers. Social stressors, psychosocial work factors, working hours, sleep and night shift work, and sedentary behavior are associated with obesity among workers.3 In addition, food contamination due to the environment, including work environment, increases health risks in the workplace.4 This situation is certainly threatening because it is also a determinant variable of presenteeism and reduces productivity. Many programs have been carried out to prevent and control these health and nutrition problems, including health and nutrition promotion, supplementation of iron tablets, and food fortification. The program's success will undoubtedly be improved by making the workplace a setting for activities towards a healthy workplace. World Health Organization5 defined "a healthy workplace is one in which workers and managers collaborate to use a continual improvement process to protect and promote the health, safety and well-being of all workers and the sustainability of the workplace". The principles of approach to workplace health promotion are addressed at the underlying causes of ill health, combining diverse methods of interventions. Workplace health promotion is aimed at effective worker participation and is not partially based on medical activities but should be part of the work organization and working conditions. These approaches are in line and build a synergy with the goals of the occupational health services that are devoted to the prevention and management of occupational and environmental injury, illness and disability, and the promotion of health and productivity of workers, their families, and communities. In practice, the goals of the occupational health service are to protect the workers against any occupational hazard, to contribute towards harmonious human-machine relationships and to establish and maintain the workers' physical and mental well-being.6 The bottom line of workplace-based health and nutrition intervention is the worker's healthy behavior and balanced nutrition practices. Workplace health promotion should be done by implementing health promotion strategies focusing on the individual and their lifestyle behavior change and creating healthy work organizations and environments. In the case of nutritional deficiencies, improving diets may be more appropriate, and workplaces are an excellent setting to improve the nutritional quality of diets. Nutrition promotion is the basis of the strategic approach to address nutrient deficiency anemia. Workplaces appear as the main entry point: workers are generally healthy and productive, and nutrition activities may also reach the workers' families. Mansyur7 proposed integrating nutrition education, factory canteen and health services improvements. Workplace-based nutrition education effectively improves female workers' knowledge and practices of balanced nutrition and healthy habits. The service of the company canteen plays an important role in providing nourishing meals and compensating for family food shortages due to financial constraints and cultural barriers. In addition, factory health services strengthen their activities with health promotion and preventive approach via workplace hazard prevention and control, and minimizing the risk of occupational and environmental food contaminants.

Objectives: Shift work results in changing worker’s behavior, food, and sleep patterns, which can cause circadian rhythm disturbance, which is a cardiovascular risk. Until now, a biomarker of early prediction of cardiovascular risk on shift workers is still not developed. This study aimed to assess the cardiovascular risk of shift worker nurses by detecting endothelial microparticles (EMPs). Methods: This longitudinal study compared six shift nurses and five non-shift nurses by measuring the EMPs using antigen CD31+ flow cytometry. All met the inclusion criteria consisting of 28 blood samples followed in one week shift. Results: EMPs among non-shift nurses were below 200 μL. However, shift nurses’ EMPs increased above 200 μL with Man-Whitney U p = 0.000 on days 4 and 7 following a one shift per week schedule. Conclusion There was an increase in shift workers’ endothelial microparticles (EMP) which was a sign of cardio-vascular risk.
Heart Disease Risk Factors ; Nurses

Return to work assessment (RTWA) has been performed to a radiographer assistant suffering a hemianopsia due to an ischemic stroke. Stroke occurred two months prior to the examination. The general condition of the patient was good. The systemic examination was unremarkable except the presence of a partial vision loss in the left eye and often feeling fatigue and down. Perimetry Full-field 120 Point Screening Test confirmed a left temporal hemianopsia while Patient Health Questionnaire’s score (PHQ-9) indicated a moderate depression. The two conditions were not fully compatible with the job demand of a radiographer assistant, which required a complete and clear visual field as well as a good mental status. Risk assessment indicated that the patient might encounter health and safety issues if he resumed duty without work adjustment. The clinic still wanted to employ the patient and agreed to provide support. The patient was declared ‘fit’ to resume his duty with some recommendations.

Multiple traumas require a fast and comprehensive treatment to overcome challenges that emerge from the patient’s condition. The right time for trauma team activation is necessary to treat these multiple trauma patients to improve patient outcomes. This integrative review identifies the criteria used to activate the trauma team, the activation process and the outcome of the activation. The search was conducted from January to March 2023 with two databases, namely MEDLINE and PubMed, and grey literature via Google Scholar. The search was limited to articles written in English, with abstracts and available in full text. There was no year limitation. The review found four criteria that were used for trauma team activation: physiological, anatomical, mechanism of injury and others. The process of trauma team activation begins in the pre-hospital setting. Outcomes used to evaluate the impact of trauma team activation included the level of satisfaction of patients and families, the level of complaints, response time, discharge status, and mortality. The findings of this review recommend that the criteria, process, and outcomes of trauma team activation are tailored, based on the needs and available resources of the institutions. Moreover, standardized trauma team activation may be necessary for future development.

Objective: The objective of our study was to determine the genotype frequencies of CYP2C19*2 and *3 gene polymorphisms among Javanese farmers exposed to chlorpyrifos (CPF) in Central Java, Indonesia. Methods: This cross-sectional study was conducted from July to October 2020 in Central Java, Indonesia, involving 151 vegetable farmers aged 18-65 years who used CPF for at least one year. CYP2C19*2 and *3 gene polymorphisms were analyzed using PCR-RFLP. Direct calculations were applied to calculate allele and genotype frequencies. The difference in genotype frequencies among the sex and cumulative exposure level (CEL) group was performed using the Chi-square test. In contrast, the proportion difference of allele frequencies was analyzed using Z-test. Results: The frequency of CYP2C19 genotypes *1/*1, *1/*3, *1/*2, and *2/*2 were 64 %, 7 %, 23 % and 6 %. We observed no significant difference in the genotype distribution according to sex group and CEL group. Conclusion In summary, the prevalence of toxicologically relevant CYP2C19 polymorphisms was determined in the Javanese agricultural population. The CYP2C19 genotype may be helpful as an essential biomarker of genetic susceptibility towards CPF exposure. Nevertheless, further studies to confirm the role of CYP2C19 in this context are still needed.
Cytochrome P-450 CYP2C19 ; Pesticides