Jurnal Kesehatan

Molecular Mechanisms and Therapeutic Potential of Soy Isoflavones in Breast Cancer: A Narrative review

Dewi Rusnita — 2026-07-30

Breast cancer remains a multifaceted disease requiring deeper understanding of dietary interventions. Soy isoflavones represent a promising area of investigation. Despite extensive research, a synthesis of insights from laboratory, animal, and human research to elucidate mechanisms by which soy isoflavones could be used for preventing and treating breast cancer remains lacking. This review analyses recent findings laboratory, animal and human research to clarify molecular mechanisms of soy isoflavones in breast cancer prevention and treatment. Soy isoflavones, particularly genistein and daidzein, influence cell proliferation, cell cycle regulation, apoptosis induction, epigenetic modifications, cell signalling pathways, angiogenesis, and metastasis in breast cancer models. These compounds modulate expression of crucial genes and proteins participate in these processes, such as p21, Bax, Bcl-2, BRCA1, and BRCA2, and disrupt essential cancer signalling pathways. Soy isoflavones impact breast cancer cell metabolism, particularly glucose, lipid, and nucleotide metabolism, through effects on the pentose phosphate pathway. These compounds demonstrate immunomodulatory properties, influencing immune cell recruitment and signalling in the breast cancer microenvironment. While soy isoflavone effects vary based on dose, timing of exposure, and tumour subtype, evidence suggests their potential as chemopreventive agents, warranting further clinical investigation.

Continuity of Care by Midwifery Students Promotes Women's Self-Efficacy and Expectations

Sri Wahyuni — 2026-07-30

Background: Despite the documented benefits of continuity of care for both pregnant women and midwifery students, research on the self-efficacy and expectations of mothers who receive continuity of care from midwifery students remains limited. Objectives: Exploring the self-efficacy and expectations of mothers who receive continuity of care provided by midwifery students. Methods: This study employed a descriptive-analytic design with a cross-sectional approach. A total of 80 mothers who received continuity of care from midwifery students between June and August 2023 participated in the study and provided written informed consent. Data were collected using a self-efficacy and an expectations questionnaire. Participants also completed a demographic characteristics form. The data were analyzed and presented in the form of frequency distributions. Results: The mean age of participants was 30.40±7.39 years. Most participants had a secondary education (50%), unemployed (57.5%), primigravida (52.5%). Self-efficacy was assessed in three aspects: perceived difficulty level (good in 77%), strength of belief (good in 73%), and scope of knowledge (good in 76%). Most mothers reported experiences that met their expectations during pregnancy (90%), labor (83.8%) and the postpartum and breastfeeding period (88.8%) while receiving continuity of care from midwifery students. Conclusion: The CoC model implemented by midwifery students is effective in enhancing pregnant women’s self-efficacy and satisfaction throughout the antenatal, intrapartum, and postnatal periods. It is essential for midwifery students to establish effective and trusting relationships with women to ensure the successful implementation of continuity of care.

The Effectiveness of Nurse Home Visits in Improving Caregiving Skills and Reducing Family Burden among Post-Stroke Patients after Hospital Discharge

Yaslina Amzah — 2026-07-31

Stroke patients who return home after hospitalization may continue to experience residual symUniversityoms that affect their daily activities, thereby requiring ongoing care from family members. However, families of post-stroke patients are often unprepared to provide care due to limited knowledge and caregiving skills, which may also lead to an increased caregiver burden. Inadequate caregiving skills and high caregiver burden can negatively affect the quality of care and the recovery of post-stroke patients at home. Therefore, continued post-hospital care through nurse-led home visits is necessary. This study aimed to examine the extent to which nurse-led home visits can improve caregiving skills and reduce caregiver burden among families of post-stroke patients, particularly in Bukittinggi and Agam. This study employed a quasi-experimental pretest–posttest design conducted over a four-month period from February to August 2023. The study population consisted of families with post-stroke patients after hospital discharge. Samples were selected using convenience sampling at M. Hatta Brain Hospital, Bukittinggi, with a total of 56 respondents (28 in the intervention group and 28 in the control group). Caregiving skills were measured using a skills questionnaire [1], while caregiver burden was assessed using the Caregiving Burden Instrument [2]. Statistical analysis was performed using independent and paired t-tests. The home visit program was conducted over four months and included training, education, and counseling for family caregivers. The results showed significant differences in caregiving skills and caregiver burden between the intervention and control groups after four months (p < 0.001). Furthermore, home visits were proven to be effective in improving family caregiving skills and reducing caregiver burden among post-stroke families in the intervention group in the second and fourth months (p-values for skills: 0.015 and 0.000; p-values for burden: 0.000 and 0.001). It can be concluded that home-based caregiving skills can be improved and family caregiver burden can be reduced through nurse-led home visits conducted over a four-month period. Therefore, intensive and varied home visit methods by community nurses are strongly recommended for families of post-stroke patients after hospital discharge

Mobile-Based Early Detection of Stunting Using Risk Factors in Gunungkidul Regency, Special Region of Yogyakarta

REVITA SUSANTI — 2026-07-30

Background: In 2017, out of 11 countries in Southeast Asia, Indonesia ranked second for the country with the highest number of stunting events, 36.4%. The need for screening / early detection of stunting based on risk factors to prevent stunting in children. Purpose: To detect the risk of stunting based on mobile-based risk factors in Gunungkidul Regency, Yogyakarta. Methods: This research is an analytic survey with cross sectional approach. The sample was 98 mothers and their children aged 6-12 months with a quota sampling. In determining stunting risk categories based on risk factors, a data mining process is carried out using the C4.5 algorithm in predicting stunting in children with the results of categories in the form of risk and no risk of stunting. Data analysis was performed using univariate analysis, D2S application validity test (Deteksi Dini Stunting), and D2S application system feasibility test. Results: The results of the D2S application validity test found a sensitivity value of 20% (95% CI 5.67% -50.98%), specificity 97.73% (95% CI 92.09% - 99.37%) and an accuracy of 89.79%. Based on the results of the feasibility test application using the user acceptence questionnaire on 20 users it was found that as many as 19 people (95%) stated that the D2S application was very feasible and as many as 1 person (5%) stated it was fit to use. Conclusion: The D2S application is less sensitive in detecting the risk of stunting in children, but is very precise in detecting no risk of stunting in children.

DETERMINANTS OF ANTIRETROVIRAL THERAPY ADHERENCE AMONG PEOPLE LIVING WITH HIV IN NORTH SUMATERA, INDONESIA

Lidya Hutapea — 2026-07-30

Background: Human Immunodeficiency Virus (HIV) continues to pose a major global public health challenge, especially in low and middle income countries. Sustained adherence to Antiretroviral Therapy (ART) is fundamental to achieving viral suppression, preventing disease progression, and reducing transmission. Despite advances in treatment availability, suboptimal adherence continues to hinder optimal clinical outcomes.

Aims: This study aimed to examine the key determinants influencing ART adherence among people living with HIV (PLHIV) in North Sumatra, Indonesia.

Methods: A quantitative cross-sectional study was conducted from April to December 2024 at Dr. Ferdinand Lumbantobing General Hospital, Sibolga City. All 88 PLHIV receiving ART during the period were recruited using total sampling. Data were collected via structured questionnaires and analyzed using univariate analysis, chi-square tests, and multivariate logistic regression to identify significant adherence predictors.

Results: ART adherence was significantly associated with treatment-related knowledge, family support, healthcare provider support, and access to healthcare facilities (p < 0.05). Multivariate logistic regression revealed that treatment knowledge was the most influential determinant of adherence, followed by family support, healthcare provider support, and healthcare accessibility.

Conclusion: ART adherence in this tropical setting is shaped by a dynamic interplay of individual understanding and social and healthcare system support. Strengthening patient education, fostering family engagement, and improving access to healthcare services are essential strategies for sustaining treatment adherence over time. Future longitudinal research is warranted to explore adherence trajectories and evaluate targeted intervention models

Therapeutic Potential of Topical Metformin in Diabetic Wound Healing: Preclinical Mechanistic Insights

Citra Safitri Wirman — 2026-07-30

Diabetic wounds remain one of the most challenging complications of diabetes mellitus, largely due to persistent inflammation, oxidative stress and impaired tissue regeneration. These conditions contribute to delayed healing and increase the risk of infection and amputation. In recent years, topical metformin has gained attention as a potential therapeutic option to improve wound healing outcomes. This review aims to summarize current preclinical evidence on the effectiveness of topical metformin, with a particular focus on its underlying molecular mechanisms. Evidence from experimental studies suggests that topical metformin can accelerate wound healing through several interconnected pathways, including activation of AMP-activated protein kinase (AMPK), suppression of NF-κB–mediated inflammation, reduction of reactive oxygen species (ROS) and regulation of extracellular matrix remodeling. Moreover, the advancement of sophisticated delivery technologies, such as hydrogels and nanocomposites has significantly augmented the localized therapeutic efficacy of metformin. The evidence suggests that topical metformin may be a new way to treat diabetic wounds. However, additional rigorously planned studies and clinical trials are necessary to validate its safety, enhance its formulation and facilitate its clinical use.

Keywords : AMPK activation; Diabetic wound; Inflammation; Preclinical evidence; Topical metformin

Effectiveness of a LATCH-Based Midwife Training Program on Breastfeeding Attachment and Mastitis Risk: A Randomized Controlled Trial

mutiaradwiyanti — 2026-07-30

Background: Most literature indicates that direct contact between health workers and postpartum mothers, even when the mother is not in the hospital, is a significant intervention. In this model, health workers face time and distance constraints in implementing the intervention. This study proposes an intervention model based on education and additional training for midwives. This improvement in midwives' knowledge and skills is expected to significantly contribute to breastfeeding practices. Objective: This study aims to analyze the effectiveness of LATCH score-based midwife training on breastfeeding attachment quality (latch) and reducing the risk of mastitis. Methods: This study involved 130 postpartum mothers at Sembiring Hospital, North Sumatra Province, Indonesia. Randomization was conducted at the level of the mothers, who were allocated to the midwives on duty. Data collection was carried out from June to August 2025 and was divided into three periods. Data were analyzed using descriptive statistical methods, the Mann–Whitney test, and the Chi-Square test. Results: The breastfeeding practice profiles of the study participants have been described. The mean LATCH scores for each period were 6.16 (±1.69), 7.13 (±1.71), and 7.47 (±1.70). Statistically significant differences in LATCH scores were found between the intervention and control groups at each period. A significant association between group type and mastitis incidence was observed only in the early postpartum period and was not significant after maternal discharge. Conclusion: Training is effective in the short term, but for long-term impact a more comprehensive model is needed.