The Effectiveness of Santri’s Life Style Management on Santri’s Coping Mechanisms

BACKGROUND: Santri is someone who is studying to deepen knowledge about Islam seriously in boarding school. Life changes will be experienced by Santri. Santri who is used to living at home and living dependent on their parents is then required to live in Islamic boarding schools so that Santri must accept unexpected conditions. Santri must change their previous life habits and have to adapt back to everyday life that is already different, for example, in making decisions, solving problems, and completing responsibilities as a student, when Santri has been given a choice, the Santri is expected to be able to accept it. AIM: The purpose of this study was to analyze the effect of lifestyle management on the coping mechanisms of Santri. METHODS: The design of this research is quasi-experimental (pre-and post-test control group design). The samples in this study were Santri in Islamic boarding schools in Surabaya and Sidoarjo which were taken by probability sampling (multi stage sampling) with 78 treatment groups and 75 control groups. Data analysis used t test with a significance value of p < 0.05. This research questionnaire uses that the coping mechanism (Jalowiec Coping Scale) has reliability (r = 0.8) and the validity test gets that the Cronbach alpha value is 0.7. RESULTS: The Santri’ coping mechanisms in the intervention group were 68.6 (adaptive coping mechanisms) and 45.7 in the control group (maladaptive coping mechanisms) with p = 0.00. The results of the paired t-test statistical test obtained p = 0.000 in the intervention group and obtained p = 0.35 in the control group, p < 0.05, it can be concluded that there is a significant change in the coping mechanisms of Santri before and after being given lifestyle management interventions in intervention group and control group. CONCLUSION: Lifestyle management is effective in improving Santri’ coping mechanisms in dealing with a problem.

Usage of Smartphone Apps in Self-care of Patients Undergoing Hemodialysis: A Scoping Review

Aim: Using smartphone apps can be a valuable tool for self-managing dialysis patients. This study aimed to review the usage of smartphone apps in the self-care of patients undergoing hemodialysis. Method: Resources were searched on three bibliographic databases, including PubMed, Scopus, and CINAHL, investigated from May 2005 through May 2021, using key terms, such as smartphone apps, mobile health, hemodialysis, chronic kidney disease, self-care, and self-management. Selecting articles were based on the PRISMA flow diagram. Results: The smartphone apps used for undergoing hemodialysis patients were categorized into five main categories. These categories included dietary monitoring, treatment adherence, lifestyle management, symptoms monitoring, and patient training. Conclusion: Smartphone apps must be developed by cooperation and supervision of healthcare agencies to improve patient adoption and ensure confidentiality. Further research efforts are needed to assess the impact of apps on quality of life outcomes through randomized controlled trials and cohort studies. In developing apps, the needs and preferences of patients must be considered.

Prerenal Transplant Education and Evaluation Positively Impacts Outcomes

Introduction: An outstanding question in kidney transplantation is how to prepare candidates and their social supports for optimal posttransplant outcomes. Project Aims: This program evaluation assessed whether a pretransplant quality improvement clinic improved clinical outcomes in the year posttransplant compared to recipients receiving standard of care. Design: The Countdown to Transplant Clinic was implemented with kidney transplant candidates expected to receive a transplant within the next few months. The clinic included an enhanced education session on posttransplant lifestyle management, confirmation of support (≥2 adults), and evaluations by transplant social work, psychology, and nephrology. Results: Seventy-five patients participated in the clinic and underwent a transplant. A retrospective chart review of posttransplant laboratory values, rehospitalizations (within 3-months posttransplant), biopsy-confirmed graft failure, and mortality (within 1-year posttransplant) were collected from both groups. Univariate and multivariate propensity score-weighted linear or logistic regression models were used to evaluate the association between clinic participation and outcomes. In models adjusting for relevant covariates, participation in The Countdown to Transplant Clinic (vs standard care) was associated with a lower coefficient of variation of serum tacrolimus (all values collected 3-12 months posttransplant), 30-day posttransplant white blood cell counts (but not 90-day), 90-day posttransplant potassium, and 30 and 31 to 90 days rehospitalizations. Clinic participation did not predict serum glucose levels at 30- or 90-days posttransplant. Due to low rates of rejection and mortality, meaningful comparisons were not possible. Conclusion: Participation in a pretransplant, multicomponent clinic may improve certain outcomes of interest posttransplantation. Pilot testing for feasibility for randomized controlled trials is a necessary next step.

Assessment of a Clinical Case for A Female Patient with Type 2 Diabetes Using the 2021 Consensus Report on Type 2 Diabetes Remission Discussions Sponsored by American Diabetes Association Based on GH-Method: math-physical medicine (No. 506)

This 73-year-old female patient has suffered from type 2 diabetes (T2D), hypertension, and hyperlipidemua for over 20 years. She started taking Metformin in 1999 and ceased taking it on 1/7/2019. As of 4/3/2019, her HbA1C level was at 6.6%. Since 4/4/2019, she implemented a lifestyle management program which not only focuses on diet and exercise but also factors in sleep, stress, life routines and habits, as well as environmental factors. In this article, the author applies the final conclusions from the American Diabetes Association (ADA) 2021 consensus report regarding “T2D Remission”. For this clinical case, he analyzes the patient’s present conditions to determine if she satisfies the criteria of “T2D remission” or not. The defined criteria of “remission” include timespan of at least one year, HbA1C level less than 6.5%, fasting plasma glucose (FPG) level less than 126 mg/dL, and estimated HbA1C (eA1C) values based on the mean continuous glucose monitoring (CGM) glucose data less than 6.5%. In conclusion, according to the ADA 2021 consensus report, this female patient is in “remission” for T2D. In summary, over the past year from 9/5/2020 to 9/5/2021, her average lab-A1C is 6.3%, mean CGM FPG value is 102 mg/dL, and CGM eAG is 5.7%. First, the selected one year satisfies the timespan requirement cited in the 2021 consensus report. Her set of glucose data has been collected over ~3 years, after post-Metformin (started on 1/7/2019) and her initiation of lifestyle management program that began on 4/4/2019. Second, all of her A1C values, both lab-tested and CGM eA1C, are less than 6.5% and her mean CGM FPG level is less than 126 mg/dL. Finally, she keeps a regular routine with quarterly medical examinations to monitor various diabetes complications, including macrovascular, micro- vascular, neural, and hormonal systems. The author understands and agrees with the consensus report that diabetes is non-curable and at most is “controllable” or “partially reversible”. Nevertheless, this female patient has also adopted a similar lifestyle improvement program as the author in order to deal with the root causes of her multiple metabolic disorders, particularly T2D, instead of suppressing the external symptoms of diabetes through medication intervention.

Investigation of Expected Longevity Using Medical Conditions and Lifestyle Details to Calculate A Female Patient’S Health Age Based on GH-Method: Math-Physical Medicine (No. 490)

The author was a mathematician and an engineer. His view of longevity is similar to his past experience on designing and building a structure or a machine which he calls an “object”. The expected lifespan of an object is similar to the longevity of a human being based on the following three factors: (1) The availability of good and strong building materials that are similar to the genetic factors of a human body health conditions. (2) The engineering design and site construction of this object are similar to the lifestyle, life-long habits, and environmental factors which are related to the health of the human body. (3) The building’s damaged cracks or the machine’s malfunctioned parts under external forces are similar to the medical conditions and symptoms of disease in the human body. If the object suffers from operational problems due to external forces that is similar to the human body being affected by various diseases, then we can repair the object such as adopting the reinforcement of the building structural part or replacing the operational part of the machine. They are similar to the medical treatments including medication interventions, different surgeries, or organ transplants. Once the author understood the analogy and similarity between an engineering object and a human body, he can then distinguish the differences among genetic reason, lifestyle maintenance, disease control, and medical treatments. It is extremely difficult, almost impossible at present time, to change our genes because we cannot select our biological parents; however, we can focus on our daily lifestyle management to either prevent from having diseases or controlling the progression of existing diseases.

The Change in Health Biomarkers for Bodyweight and Glucoses Between the PreVirus Period and COVID-19 Period Based on GH-Method: Math-Physical Medicine (No. 468)

This paper describes the author’s quantitative improvements on his weight and glucose resulting from lifestyle modifications. Special attention has been placed on both the pre-virus period from 5/5/2018 to 1/18/2020 (total 624 days with 1,934 meals and snacks) and the COVID-19 quarantined period from 1/19/2020 to 6/16/2021 (total 514 days with 1,536 meals). This article emphasizes on bodyweight, glucoses, and glucose fluctuations (GF) during the two compared periods. In general, his health conditions of weight and glucoses in the COVID-19 period (514 days) are better than his health conditions in the pre-virus period (624 days). The COVID-19 pandemic is more than 100 times worse than SARS that occurred in 2003, in terms of its spreading speed, fatality number, and emotional impact on the world population. People belonging to the “vulnerable” groups” such as the elderly, with existing chronic diseases and history of complications, require special attention to their health conditions and lifestyle management during this COVID-19 quarantine period. In this particular period, the author achieved better results on both his diabetes control and overall metabolism management. The knowledge and experience he has gained in the past 11 years of medical research and his developed metabolism index (MI) model along with his four diabetes prediction tools assisted him in many ways. During the quarantine period, he has stopped traveling and suffered no jet-lag, eating home-cooked meals, maintaining nutritional balance, continuing his daily walking exercise of 16,000 steps (~10.7 km or 6.7 miles each day), sleeping 7.2 hours each night, living a stressfree life, avoiding negative news of politics and the pandemic, and keeping a regular daily life routine. The author enjoys conducting medical research, which is his obsessive hobby, and does not need to make a living off his work. Therefore, he feels no pressure at all to continuously perform research over the past 11 years. As a result, he has actually turned the COVID-19 crisis into his health advantage!