Diabetes mellitus (DM) is a chronic disease and a major health problem globally. Estimates suggest that in 2019, there were 63 million people in the world living with DM and that number is expected to rise to 578 million by 2030 and 700 million by 2045 (International Diabetes Federation, 2019). In Indonesia, there are approximately 10.7 million people living with DM in 2019 and that number is predicted to rise to 13.7 million in 2030, and 16.6 million by 2045 (International Diabetes Federation, 2019). An increasing number of people with DM will lead to increasing numbers of DM-related complications, such as retinopathy, nephropathy, and foot ulcers

The aim of this study was to clarify the relationship between maceration and wound healing. A prospective longitudinal design was used in this study. The wound condition determined the type of dressings used and the dressing change frequency. A total of 62 participants with diabetic foot ulcers (70 wounds) were divided into two groups: non-macerated (n = 52) and macerated wounds (n = 18). Each group was evaluated weekly using the Bates-Jensen Wound Assessment Tool, with follow-ups until week 4. The Mann-Whitney U test showed that the changes in the wound area in week 1 were faster in the non-macerated group than the macerated group (P = 0·02). The Pearson correlation analysis showed a moderate correlation between maceration and wound healing from enrolment until week 4 (P = 0·002). After week 4, the Kaplan-Meier analysis showed that the non-macerated wounds healed significantly faster than the macerated wounds (log-rank test = 19·378, P = 0·000). The Cox regression analysis confirmed that maceration was a significant and independent predictor of wound healing in this study (adjusted hazard ratio, 0·324; 95% CI, 0·131-0·799; P = 0·014). The results of this study demonstrated that there is a relationship between maceration and wound healing. Changes in the wound area can help predict the healing of wounds with maceration in clinical settings.

Background It is well known that diabetes mellitus (DM) affects health-related quality of life (HRQOL) in both younger (aged 18–64 years) and older adults (aged ≥ 65 years). However, to date, no study has compared HRQOL and its predictors between younger and older adults with DM in Indonesia. Such a comparison is important because the results can guide nurses and clinicians to establish evidence-based educational programs that are specific and suitable for patients. Therefore, the aim of this study was to investigate the difference in HRQOL and its predictors in younger and older adults with DM in Indonesia. Methods A cross-sectional study was conducted on 641 patients with type 2 diabetes mellitus (T2DM) who were recruited via simple random sampling from 16 primary health centers in Banyumas Regency, Indonesia. A self-administered questionnaire containing the Summary of Diabetes Self-Care Activities, the DDS17 Bahasa Indonesia, the Beck Depression Inventory II, the Self-Efficacy for Diabetes Scale, the Family APGAR, and the 36-item Short-Form Health Survey was used to measure diabetes self-management (DSM), diabetes distress (DD), depression, self-efficacy, family support, and HRQOL, respectively. Independent t-tests were used to compare the physical component summary (PCS) and mental component summary (MCS) scores between younger and older adults with T2DM. Hierarchical multiple regression analyses were used to examine the factors associated with HRQOL in both groups. Results PCS scores were significantly different between the two groups. Older adults reported lower PCS scores than younger adults. No differences between the two groups were observed in the MCS scores. The hierarchical multiple regression analysis showed that level of education, employment status, number of diabetes-related complications, DSM, DD, depression, and self-efficacy were significant predictors of HRQOL in younger adults, while income, depression, DD, and self-efficacy were significant predictors of HRQOL in older adults. DD was the strongest predictor of HRQOL in younger adults, and depression was the strongest predictor in older adults. Conclusion Older adult patients had lower PCS scores than younger adult patients. This study is the first to show that the predictors of HRQOL differ between younger and older adults with T2DM. It provides insights for nurses and clinicians in Indonesia to establish evidence-based, age-specific educational programs.

The purpose of this study is to evaluate and clarify the effect of Indonesian honey, two types of Japanese honey and hydrocolloid dressing on wound healing process. Four groups of male mice were treated to produce two circular full-thickness skin wounds on the dorsum. They were then randomly allocated to receive daily Indonesian honey, Japanese honey (Buckwheat and Acacia honey) or hydrocolloid dressing as a control for treatment application. Macroscopic findings were observed from day 0 to 14 after wounding. Microscopic evaluation was assessed using qualitative analysis. The ratios of wound areas for honey groups on day 3 and 7 were smaller than those of the control group. Wound areas of honey groups gradually decreased to almost the same wound area as the control group on day 14, while the wound area of the control group peaked on day 5 and rapidly decreased until day 14. Microscopic finding that Indonesian honey was different with Japanese honey especially Buckwheat honey.

Purpose: Not all obese people have hyperglycemia. We wondered about the healing progress in obese people without hyperglycemia. The purpose of this study is to observe the cutaneous wound healing process. Methods: Three-week-old male mice were fed high-fat diets (containing 60% fat) in the diet group, and commercial diets in the control group, ad libitum for 15 weeks. Circle-fullthickness cutaneous wounds were made on the dorsal skin of mice. From day 0 to day 15 after wounding, we analyzed wound healing process. We measured the blood concentration of leptin, and observed the distribution of leptin-positive cells in each wound. Results: Mean body weight, the areas of subcutaneous fat and visceral fat, and the weight of epididymal fat in the diet group were significantly greater than those in the control group at 15 weeks after feeding. The diet group did not feed on the diet after wounding; their body weight decreased remarkably to the level of the control group. The ratio of wound area, re-epithelialization, and collagen fibers did not differ between the diet and control groups on each day. The blood concentration of leptin in the diet group was significantly greater than that in the control group before wounding and until day 6 after wounding (day 0, 10 hour and day 1: p < 0.01, day 6: p < 0.05). Conclusion: The results show * Corresponding author. T. Urai et al. 1016 that the wound healing process is similar between obese and non-obese mice, and that the decrease in the leptin level in the obese mouse to that in the non-obese mouse may depend on the decrease of body weight of obese mouse.

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There is a national shift in the new Indonesian curriculum towards employing differentiated learning approaches in addressing the diversity of students’ needs and abilities. A teachers’ judgment evidently corresponds to the duty required of physics teachers to monitor their students at an individual level. Within the context of Indonesian physics education research (PER), empirical study addressing this subject is still lacking. To fill this gap, eight Indonesian physics teachers’ experiences and limitations about their judgments within differentiated learning environments have been investigated through phenomenological study. Physics teachers were voluntarily recruited after they declared their endorsement and personal consent to participate in the study. Our participants were distributed over several teaching experiences, geographic regions, and information and communication technology (ICT) experiences. The latter experience might be taken into account since, through this study, upcoming developmental research will be projected on engaging recent technological approaches to address the limitations of teachers’ judgments. Online semi-structured interviews (~50 min) were conducted by the first author to all physics teachers involved. Other authors contributed in reviewing the interview protocol and training the first author’s pilot interview. The model of teachers’ thought and action, from Clark and Peterson, was implemented to uncover physics teachers’ experiences and limitations in making judgments within a diverse group of students. The findings revealed that physics teachers have conceded that they should dynamically adapt the learning process in order to meet heterogeneous students’ performances. Personal observation has mainly informed teachers in identifying students’ differences. After students have been identified, the teachers creatively designed learning transformations to accommodate the wide spectrum of students’ abilities. Nevertheless, several limitations were discovered as being encountered by physics teachers, particularly in terms of judgments’ equity and accuracy, as well as the teachers’ workloads. To overcome this, the teachers indicated various and supportive attitudes about technological implementations that would assist their judgments. Ideas for technological development were provided to address identified obstacles during the teachers’ judgments.

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