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Foot ulcerations are one of the most common complications of diabetes and one of the major initial causes of amputations. The formation of biofilms on wounds significantly contributes to infections and delayed healing. While existing methods for identifying these biofilms have limitations, there is a need for a convenient tool for its clinical application. This literature review aimed to address the problem with current clinical biofilm identification in wound care and a proposal for biofilm-detection-based wound care in diabetic foot ulcer patients. Identifying biofilms is particularly vital due to the absence of typical signs of infection in DFUs. However, current approaches, although effective, often prove invasive and technically intricate. The wound blotting technique, involving attaching a nitrocellulose membrane and subsequent staining, presents an alternative that is swift and non-invasive. Research highlights the applicability of wound blotting with alcian blue staining in clinical scenarios, consistently producing sensitive outcomes. By addressing the critical need for early biofilm detection, wound blotting holds promise for enhancing DFU management and contributing to strategies aimed at preventing amputations., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Edible insects are a novel source of animal protein. Moreover, edible insects contain iron concentrations similar to meat, potentially making them a valuable iron source for human consumers. Yet, it is unknown to what extent iron from insects is absorbed in humans., Objectives: In this exploratory study, we assessed fractional iron absorption from house crickets (Acheta domesticus) consumed with refined (low-phytate, noninhibiting) or nonrefined (high-phytate, inhibiting) meals., Methods: Intrinsically [57Fe]-labeled and control crickets were reared. Six iron-balanced experimental meals were randomly administered crossover to 20 iron-depleted females (serum ferritin <25 µg/L; 18-30 y old), in 2 time-blocks of 3 consecutive days, 2 wk apart. Three meals consisted of refined maize flour porridge with either [57Fe]-labeled crickets, [58Fe]SO4 (reference meal), or unlabeled crickets plus [54Fe]SO4. The other 3 meals consisted of nonrefined maize flour porridge with the same respective additions. Blood samples were drawn to assess the 14-d isotope enrichment in erythrocytes, and meal-specific fractional iron absorption was calculated. In vitro digestion was used to explore possible explanations for unexpected findings., Results: Mean fractional iron absorption from 57Fe-labeled house crickets with refined maize porridge (3.06%) and from refined maize porridge with unlabeled crickets (4.92%) was lower than from the reference meal (14.2%), with respective mean differences of -11.1% (95% CI: -12.6%, -9.68%) and -9.29% (95% CI: -10.8%, -7.77%). Iron absorption from all meals based on unrefined maize porridge was low (<3%), and did not differ for the 2 meals with crickets compared with the reference meal. In vitro digestion showed that chitin, chitosan, and calcium limited iron bioaccessibility to a large extent., Conclusions: Iron absorption from house crickets and fortified maize porridge with crickets is low, which may be explained by the presence of chitin and other inhibitors in the cricket biomass.This trial was registered at https://www.trialregister.nl as NL6821., (© The Author(s) 2022. Published by Oxford University Press on behalf of the American Society for Nutrition.)

ABSTRACT This review aimed to examine the bottom-up and top-down rehabilitation intervention effectiveness based on the functional outcome measure as immediate effect and long-term effect for unilateral spatial neglect conditions. The RCT studies were collected by searching in three databases J-Stage, PubMed, and PEDro from 2008 through 2018. The studies which used the following instruments: BI, CBS, FMA, and FIM, as the functional outcome with the PEDro score of six and above, were eligible for inclusion. A total of 492 participants in 13 studies included from 291 studies initially identified. The meta-analysis for overall ES revealed that BI and CBS had a significant mean of SMD = 0.65 (95% CI, 0.23-1.07; p  = 0.003; I 2  = 65%), and SMD = -0.23 (95% CI, -0.45 to -0.01; p  = 0.04; I 2  = 35%) respectively, while FMA and FIM had an insignificant mean of SMD = 0.14 (95% CI, -0.08-0.37; p  = 0.22; I 2  = 0%), and SMD = -0.22 (95% CI, -0.69-0.25; p  = 0.37; I 2  = 0%) respectively. Based on the results, although indicated the heterogeneity representation across studies, it showed that the top-down intervention approach of high-frequency rTMS was more effective in enhancing the functional abilities and ADL of unilateral spatial neglect patients on the immediate effects but not necessarily in the long-term effects.

Objective: To provide consensus on how to plan, organize and implement exercise-based injury prevention program (IPP) in sports., Design: Delphi., Setting: LimeSurvey platform., Participants: Experienced sports physical therapists from the International Federation of Sports Physical Therapy member countries., Main Outcome Measures: Factors related to sports IPP planning, organization and implementation., Results: We included 305 participants from 32 countries. IPP planning should be based on an athlete's injury history, on pre-season screening results, and on injury rates (respectively, 98%, 92%, 89% agreement). In total 97% participants agreed that IPP organization should depend on the athlete's age, 93% on the competition level, and 93% on the availability of low-cost materials. It was agreed that IPP should mainly be implemented in warm-up sessions delivered by the head or strength/conditioning coach, with physical training sessions and individual physical therapy sessions (respectively, 94%, 92%, 90% agreement)., Conclusion: Strong consensus was reached on (1) IPP based on the athlete's injury history, pre-season screening and evidence-based sports-specific injury rates; (2) IPP organization based on the athlete's age, competition level, and the availability of low-cost materials and (3) IPP implementation focussing on warm-up sessions implemented by the strength/conditioning coach, and/or individual prevention sessions by the physical therapist., Competing Interests: Declaration of competing interest LDM, CR, CN, UB are on the IFSPT executive board. The other co-authors have none declared., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Objective: The study aimed to measure achievement of the national program of cervical and breast cancer screening in Indonesia after 12 years implementation and factors associated with the number of the screening., Methods: This was a cross-sectional study with descriptive and analytic analysis. Secondary data was collected from Directorate of Non Communicable Disease Control, Ministry of Health., Results: From 2007 to 2018, the program was implemented in all 34 provinces, at 51% primary health centers (PHC) with 3 providers each. Total women aged 30-50 years screened was 3,664,625 (9.8% of the target). The number rose gradually from 2007 to 2014, with significant increase from 2015 to 2018. Bali province had the highest coverage (31%) and Papua had the lowest (1%). We found a wide disparity of coverage among provinces. There was 3.4% of VIA-positive, 16.1% was treated with cryotherapy, 1.3 per 1,000 of suspected cervical cancer, 5,4% lump in the breast, and 0.7 per 1,000 suspected breast cancer. Factors associated with number of the screening were number of PHC providing screening, number of GP, total provider, number of NCD post, number of Village with NCD Post, and income of the province., Conclusion: The cervical and breast cancer screening program was running in all provinces in more than half of primary health centers in Indonesia. National coverage (9.8%) was far below the target and varied widely among provinces. Number of PHC with screening services, number of GP, number of total provider, number of NCD post, number of Village with NCD Post, and income of the province have association with cervical and breast cancer screening.

Family members play a vital role in both helping and undermining diabetes mellitus selfmanagement practices. This qualitative study aimed to explore the potentially unmet needs of family function to support diabetes self-management (DSM) practices. In-depth interviews and focus group discussions (FGDs) were conducted among different key informants, including uncontrolled T2DM patients, caretakers and healthcare providers (HCPs) at community health centres. An open-ended approach was applied to elicit responses from the key informants. A total of 22 participants were involved in this study. All interview and FGD processes were audiorecorded and transcribed verbatim. The results found that all key informants addressed six core themes, with sub-themes to describe the unmet needs of family function to support DSM practice. The critical unmet needs of family function include: 1) Lack of problem-solving skills to deal with poor diabetes management; 2) Ineffective communication and refusal to share the burden of diabetes management; 3) Lack of affective responsiveness to encourage patients' compliance; 4) Lack of affective involvement in DSM; 5) Insufficient family roles in supporting patients; 6) Poor behaviour control of T2DM. Our findings provide insights into how family function may influence the adoption and maintenance of healthy behaviours among diabetic patients. Since health providers seek new approaches to improve DSM practices, this valuable finding was essential to understand how family function can improve and empower patients in DSM practice., (© Academy of Family Physicians of Malaysia.)

Background: Diabetes self-management (DSM) is crucial for glycemic control among type-2 diabetic (T2D) people., Method: This was a sequential exploratory mixed-method approach to assess whether a health-based coaching program designed to fit the unmet needs of T2D was the best intervention for improving DSM practice. Twenty-eight participants from different backgrounds were involved in phase 1 (Qualitative study) to explore DSM knowledge and practice, any difficulties obstructing such knowledge and practice, and the feasibility of implementing an intervention program nationwide. Sixty patients were recruited for phase 2 (Quasi-experimental study). A health-based coaching program, constructed to fit the unmet needs from phase 1 was implemented among thirty patients in an experimental group. By comparison, 30 patients in the control group received their usual care. Diabetes and DSM knowledge, DSM practice, and health outcomes were measured and compared between the two groups at baseline and after the 12th week of the intervention., Results: The following problems were found: (1) a low perception of susceptibility to and severity of illness, (2) inadequate DSM knowledge and skills, (3) a lack of motivation to perform DSM practice, and (4) social exclusion and feelings of embarrassment. After the implementation of the program among the experimental group, all the variables improved relative to baseline and to the control group., Conclusion: A health-based coaching program can improve DSM knowledge and practice and health outcomes. A nationwide program is recommended to promote DSM practice among Indonesian communities., (Copyright © 2020 SEEN and SED. Published by Elsevier España, S.L.U. All rights reserved.)

Objectives: This study sought to examine the impact of a family functional-based coaching program on improving the perceived family functioning practice and clinical outcomes among patients with glycemic uncontrolled type 2 diabetes mellitus (T2DM) in the Indonesian community., Methods: We applied a quasi-experimental study, pretest, and posttest design with a non-equivalent control group. Sixty pairs of T2DM patient-caretaker dyads were recruited and assigned to either an intervention or control group. The Family Function Questionnaire (FFQ) was used to assess the perception of family functioning practices by T2DM patients of their caretakers to support their diabetes self-management. The clinical outcomes were measured using clinical outcome devices and laboratory tests. These measurements were conducted and compared at a baseline and 12 weeks after completing the program., Results: Patients who received the family functional-based coaching program saw significant improvement in perception of family function practice, compared to the control group who received usual care. The findings also showed a positive decline glycated hemoglobin and total cholesterol levels after receiving the 12-week program. However, no significant difference was found in body mass index., Conclusions: It can be concluded that a family functional-based coaching program is feasible to implement among uncontrolled T2DM in a large scale study., (The OMJ is Published Bimonthly and Copyrighted 2020 by the OMSB.)

Childhood obesity has adverse impacts on premature mortality and morbidity. Managing obesity could prevent premature mortality and several types of complications among high-risk groups. This study aimed to review and examine the effects of home-based interventions to treat and prevent childhood obesity. Three databases, i.e., PubMed, Scopus, and Science Direct, were included to extract articles related to the topic. The terms "childhood obesity", "home-based intervention", "parental program", and "parental involvement" were used as the primary keywords. Appraisal of the systematic review was based on PRISMA formats. Of 1556 publications identified, 22 studies fulfilled the inclusion criteria and were appropriate to conduct a meta-analysis. Overall, the home-based interventions reduced the body mass index (BMI) z-score by 36.99% (z = 36.99, p = 0.00). The data analysis indicated considerable heterogeneity among all interventions (Chi-square = 926.41, df = 22 (p <0.000001), I 2 = 98%). The home-based intervention positively reduced BMI. Our findings could guide future meaningful home-based interventions to treat and prevent childhood obesity., Competing Interests: We declare no conflict of interest in this manuscript. The funding sponsors also served no role in the writing of the script or the decision to conduct this manuscript.

Electronic Medical Records (EMR) are increasingly adopted in healthcare facilities. Recently, implementation failure of electronic information systems is known to be caused by not only the quality of technical aspects, but also the user's behavior. It is known as applying the Technology Acceptance Model (TAM). This research aimed to analyze the acceptance model of p-care BPJS in the primary health centers. A total sample of 30 p-care BPJS users was drawn by multistage random sampling in which of these 30 primary health centers participated. Data analysis used both descriptive and inferential statistics. In the phase of structural model, it indicated that p-care BPJS acceptance model in the primary health centers was formed by Perceived Ease of Use (PEOU) and Perceived Usefulness (PU) through Attitude towards use of p-care BPJS and Behavioral Intention to use p-care BPJS.