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Abstrak :
This book explores how lighting systems based on LED sources have the ability to positively influence the human circadian system, with benefits for health and well-being. The opening chapters examine the functioning of the human circadian system, its response to artificial lighting, potential health impacts of different types of light exposure, and current standards in circadian photometry. A first case study analyzes the natural lighting available in an urban interior, concluding that it is unable to activate the human circadian system over the entire year. Important original research is then described in which systems suitable for artificial circadian lighting in residential interiors and offices were developed after testing of new design paradigms based on LED sources. Readers will also find a detailed analysis of the LED products available or under development globally that may contribute to optimal artificial circadian lighting, as well as the environmental sensors, control interfaces, and monitoring systems suitable for integration with new LED lighting systems. Finally, guidelines for circadian lighting design are proposed, with identification of key requirements.

Abstrak :

Respons radiasi kanker serviks diduga dapat ditingkatkan dengan pemilihan waktu radiasi tetap yang berpola sirkadian karena dianggap sesuai dengan fase radiosensitif G₂-M sel kanker. Daur sirkadian dan melatonin dianggap berperan dalam radiosensitivitas. Dihipotesiskan respons radiasi pagi hari maupun efek samping radiasi pagi hari akan lebih baik dibanding sore hari.

Penelitian ini merupakan uji klinis dengan perolehan subjek secara berurutan. Alokasi pilihan waktu radiasi pada pagi (06.00–08.00) dan sore (16.00–18.00) hari dengan randomisasi blok tiap enam subjek terpisah antara stadium II dan III. Data diperoleh menggunakan metode open label. Pengukuran data klinis seperti ukuran tumor, respons klinis, dan efek samping dilakukan oleh dua dokter independen yang terlatih. Dilakukan pengukuran kadar melatonin dan fase G₂-M siklus sel di institusi resmi. Respons baik dan buruk ditetapkan berdasarkan kriteria WHO sedangkan efek samping ada atau tidak, ditetapkan berdasarkan kiriteria RTOG.

Penyinaran di waktu pagi menunjukkan respons klinis lebih baik dibandingkan sore (p 0,025; 95% IK:1,27–33,08; adj OR: 6,48) untuk respons pascaradiasi maupun 2–4 minggu pascaradiasi (p 0,048; 95% IK 1,02–47,81; adj OR 6,98). Kadar Hb awal dan ukuran klinis tumor berpengaruh secara bermakna terhadap respons baik pascaradiasi maupun respons baik 2–4 minggu pascaradiasi. Dalam hal efek samping, pilihan waktu radiasi tidak menunjukkan hasil yang bermakna, namun kadar melatonin praradiasi berpengaruh, khususnya efek samping kulit (p 0,006; 95% IK 1,66–18,99; adj OR 5,62). Variabel yang bermakna memengaruhi efek samping terapi pada gastrointestinal adalah overall treatment time (p 0,031; 95% IK 1,19–39,93; adj OR 6,89), sedangkan untuk genitourinaria adalah PA diferensiasi (p 0,015; 95% IK 1,51–46,37; adj OR 8,36), penurunan berat badan (p 0,025; 95% IK 1,22–18,30; adj OR 4,72), dan nyeri sebelum radiasi (p 0,017; 95% IK 1,31–15,32; adj OR 4,47).

Simpulan: Respons radiasi kanker serviks uteri yang diradiasi pagi hari lebih baik daripada yang diradiasi sore hari, namun efek samping radiasi pagi hari tidak berbeda bermakna dibandingkan sore hari. Belum dapat dipastikan pengaruh besarnya proporsi fase G₂-M terhadap respons klinis radiasi. Ada kecenderungan pengaruh kadar melatonin pagi hari terhadap respons klinis radiasi dan terbukti kadar melatonin berpengaruh pada efek samping kulit.

Kata kunci: kanker serviks, melatonin, radiosensitivitas, siklus sel, sirkadian

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The radiation response of cervical cancer can be enhanced by the choice of a fixed radiation time of circadian pattern because it is considered to be in accordance with the radiosensitive phase of G₂-M cancer cells. Circadian cycles and melatonin are thought to play a role in radiosensitivity. It is hypothesized that the response and side effects of morning radiation will be better than the afternoon.

This study was an RCT (randomized clinical trials) with consecutive sampling. Treatment allocation for radiation time in the morning (06.00–08.00) and afternoon (16.00–18.00) were determined by block randomization for every six subjects based on the stage (II and III). The data was obtained with an open label method. Measurement of clinical data such as tumor size, clinical response, and side effects were carried out by two-trained independent physicians. Measurement of melatonin levels and G₂-M phases of cell cycle were carried out in official institution. Good and poor responses were set based on WHO criteria while the side effects were determined based on the RTOG criteria.

Morning radiation showed a better post-radiation and 2–4 weeks post-radiation clinical response compared with afternoon (p 0.025; 95% CI:1.27–33.08; adj OR: 6.48 and p 0.048; 95%CI 1.02–47.81; adj OR 6.98, respectively). The initial Hb level and clinical size of the tumor had a significant effect on good response both post-radiation and 2-4 weeks post-radiation. In regards to the side effects, radiation time did not show significant results in causing side effects, but pre-radiation melatonin level did on skin (p 0.006; 95%CI 1.66–18.99; adj OR 5.62). The significant variable in influencing gastrointestinal side effects was overall treatment time (p 0.031; 95%CI 1.19–3.93; adj OR 6.89), whereas for genitourinaria were differentiation of histopathology (p 0.015; 95%CI 1.51–46.37; adj OR 8.36), weight loss (p 0.025; 95%CI 1.22–18.30; adj OR 4.72), and presence of pain pre-radiation (p 0.017; 95%CI 1.31–15.32; adj OR 4.47).

Conclusion: The radiation response of irradiated uterine cervical cancer is better in the morning than the afternoon. Nevertheless, the side effects of morning radiation do not differ significantly compared to the afternoon. The influence of the G₂-M phase proportion on the clinical response to radiation cannot be ascertained. The level of melatonin in the morning might affect the radiation response and affect the side effects on skin.

Keywords: cell cycle, cervical cancer, circadian, melatonin, radiosensitivity.

Abstrak :
Perubahan gaya hidup seiring perkembangan zaman membuat kronotipe manusia semakin bervariasi. Kronotipe malam diketahui banyak dijumpai pada kalangan remaja akhir. Pola irama sirkadian memiliki hubungan dengan sistem imun dan penyakit alergi. Rinitis alergi merupakan penyakit alergi yang paling banyak dijumpai pada kalangan remaja dan dapat menurunkan kualitas hidup penderitanya. Penelitian ini bertujuan untuk mengetahui hubungan kronotipe dan rinitis alergi pada pelajar sekolah menengah atas.

Metode: Pada penelitian potong lintang ini, analisis dilakukan pada 196 pelajar sekolah menengah atas yang telah menjawab empat kuesioner: International Study of Asthma and Allergy in Childhood Core Questionnaire, Reduced Version Morningness-Eveningness Questionnaire, Epworth Sleepiness Scale dan Kuesioner Studi Kohort Faktor Risiko PTM Tahun 2011 Bagian Penggunaan Tembakau dan Kebiasaan Merokok. Data dianalisis menggunakan uji chi square dan analisis regresi logistik.

Hasil: Lebih banyak pelajar berkronotipe pagi (64,8%) dibandingkan tipe malam (35,2%). Sebanyak 28,1% pelajar mengalami rinitis alergi dalam 12 bulan terakhir. Kronotipe berhubungan signifikan dengan rinitis alergi (p<0,05; OR=2,273; CI 95% 1,198-4,311). Terdapat perbedaan proporsi rinitis alergi yang signifikan antara pelajar dengan kronotipe malam (39.1%) dan pelajar dengan kronotipe pagi (22%).

Kesimpulan: Terdapat perbedaan proporsi rinitis alergi yang signifikan antara pelajar sekolah menengah atas dengan kronotipe malam dan pelajar dengan kronotipe pagi. ......Changes in lifestyle over the times make human chronotypes more varied. The evening type are known to be frequently found among late adolescents. Circadian rhythm has a relationship with the immune system and allergic disease. Allergic rhinitis is the most common allergic disease among adolescents and can reduce the patient's quality of life. This study aims to determine the relationship between chronotype and allergic rhinitis in high school students.

Method: In this cross-sectional study, 196 high school students answered four different questionnaires: the International Study of Asthma and Allergy in Childhood Core Questionnaire, the Reduced Version Morningness-Eveningness Questionnaire, Epworth Sleepiness Scale and Kuesioner Studi Kohort Faktor Risiko Penyakit Tidak Menular Tahun 2011 Bagian Penggunaan Tembakau dan Kebiasaan Merokok. The data was analyzed using chi-square test and logistic regression.

Result: More students were morning type (64,8%) compared to evening type (35,2%). As many as 28.1% of students experienced allergic rhinitis in the last 12 months. Chronotype was significantly associated with allergic rhinitis (p<0,05; OR=2,273; CI 95% 1,198-4,311). There was a significant difference in the proportion of allergic rhinitis between high school students with evening chronotype (39,1%) and high school students with morning chronotype (22%).

Conclusion: There was a significant difference in the proportion of allergic rhinitis between high school students with evening chronotype and students with morning chronotype.

Abstrak :
Latar Belakang: Kompleks prematur ventrikel (KVP) dikaitkan dengan risiko penurunan fungsi ventrikel dan gagal jantung, dan meningkatkan mortalitas jangka panjang. Variasi sirkadian yang rendah merupakan salah satu prediktor terjadinya kardiomiopati yang diinduksi oleh KVP. KVP idiopatik tipe independen merupakan salah satu bentuk dari KVP dengan gambaran distribusi variasi sirkadian yang rendah. Namun tidak semua KVP independen memiliki variasi sirkadian yang rendah. Belum ada studi yang menilai perbedaan fungsi sistolik intrinsik VKi menggunakan global longitudinal strain (GLS) pada KVP idiopatik independen dengan KVP idiopatik non-independen. Tujuan: Mengetahui hubungan antara kompleks ventrikel prematur idiopatik tipe independen dengan GLS ventrikel kiri melalui ekokardiografi speckle tracking pada pasien tanpa penyakit jantung struktural. Metode: Penelitian ini merupakan studi potong lintang dengan menggunakan data pasien aritmia ventrikel idiopatik yang dikumpulkan di RSPJD Harapan Kita Jakarta pada bulan Februari 2021- Mei 2021. Evaluasi KVP idiopatik dilakukan dengan EKG 12 sandapan, pemeriksaan Holter monitoring 24 jam. Data dasar ekokardiografi diambil dan penilaian fungsi sistolik intrinsik ventrikel kiri (Vki) dilakukan menggunakan ekokardiografi speckle tracking dengan global longitudinal study (GLS). Hasil: Dari 67 pasien KVP idiopatik yang disertakan dalam penelitian, didapatkan sebesar 27 pasien (40,2%) dengan KVP tipe independen dan 40 pasien (59,8%) dengan KVP non-independen. Sebanyak 31 (46,3%) pasien memiliki disfungsi sistolik ventrikel kiri pada pemeriksaan GLS (kurang dari -18). KVP tipe independen (OR 5,3; IK 95% 1,10-33,29; p = 0,038), beban KVP 9% (OR 16; IK 95% 1,58-163,61; p = 0,019), jenis kelamin laki-laki (OR 6,58; IK 95% 0,80-0,99; p = 0,029), dan episode TV non-sustained (OR 13,88; IK 95% 1,77-108,53; p = 0,012) berhubungan secara signifikan dengan penurunan fungsi sistolik intrinsik Vki. Kesimpulan: Kompleks ventrikel prematur idiopatik tipe independen berhubungan dengan penurunan sistolik intrinsik ventrikel kiri melalui ekokardiografi speckle tracking. Evaluasi tipe KVP idiopatik perlu dilakukan karena berhubungan dengan prognosis pasien dalam praktik klinis. ......Background: Premature ventricular complexes (PVC) was associated with a risk of decreased ventricular function and heart failure, and increased long-term mortality. Low circadian variation is one of the predictors of PVC-induced cardiomyopathy. Independent-type-PVC (I-PVC) is a form of PVC with a low distribution of circadian variation. However, not all I-PVC show low circadian variation. No studies have been performed to examine differences in intrinsic systolic function of left ventricle (LV) using global longitudinal strain (GLS) in independent versus non-independent idiopathic PVC. Objective: To determine the relationship between I-PVC and intrinsic systolic function of LV using speckle tracking echocardiography in patients without structural heart disease. Methods: A cross-sectional study was conducted using data from patients with idiopathic ventricular arrhythmias collected at RSPJD Harapan Kita Jakarta in February 2021-May 2021. Evaluation of idiopathic PVC was carried out using a 12-lead ECG, 24-hour Holter monitoring. Basic echocardiography was performed then LV intrinsic systolic function was assessed using speckle tracking echocardiography with global longitudinal study (GLS). Results: Of the 67 patients with idiopathic PVC included in the study, 27 (40.2%) patients included in independent PVC group and 40 (59.8%) patients in non-independent PVC group. A total of 31 (46.3%) patients had LV systolic dysfunction on GLS examination (less than -18). Independent-type-PVC (OR 5.3; 95% CI 1.10-33.29; p = 0.038), PVC burden of 9% (OR 16; 95% CI 1.58-163.61; p = 0.019), male gender (OR 6.58; 95% CI 0.80-0.99; p = 0.029), and non-sustained VT episodes (OR 13.88; 95% CI 1.77-108.53; p = 0.012) was significantly associated with a decrease in LV intrinsic systolic function. Conclusion: Independent-type-PVC was associated with decreased in LV intrinsic systolic function assessed by speckle tracking echocardiography. Evaluation of the type of idiopathic PVC needs to be considered since it is related with patient's prognosis in clinical practice.

Abstrak :
Penelitian ini dimaksudkan untuk menemukan hubungan antara tipe kepribadian, tipe circadian dengan sikap terhadap sistem kerja shift rotasi. Kepribadian adalah suatu yang unik dan khas pada diri setiap individu yang mempengaruhi cara penyesuaian dirinya terhadap lingkungan. Ada dua tipe kepribadian yaitu extravert dan introvert. Circadian adalah suatu ritme perubahan fungsi-fungsi tubuh individu yang terjadi dalam waktu 24 jam. Ada dua tipe circadian yaitu tipe siang dan tipe malam, sedangkan sikap terhadap sistem kerja shift rotasi adalah perasaan positif atau negatif terhadap sistem kerja shift tersebut. Selain untuk menemukan hubungan, penelitian ini juga dimaksudkan untuk menemukan perbedaan sikap terhadap sistem kerja shift rotasi antara pekerja dengan kepribadian yang cenderung extravert dan pekerja dengan kepribadian yang cenderung introvert, serta antara pekerja dengan tipe circadian siang dan pekerja dengan tipe circadian malam. Penelitian dilaksanakan di PT SC yang pekerjaannya menuntut tingkat aletness (kesiagaan) tinggi. Sebanyak 214 pekerja bagian produksi dari perusahaan tersebut dijadikan sampel penelitian. Data dikumpulkan melalui angket Sikap terhadap sistem kerja shift rotasi, angket Kepribadian dan angket Circadian. Untuk menemukan hubungan antara tipe kepribadian dengan sikap terhadap sistem kerja shift rotasi, dan hubungan antara tipe circadian dengan sikap terhadap sistem kerja shift rotasi, dilakukan perhitungan korelasi bivariate. Analisis dilanjutkan dengan perhitungan regresi berganda untuk mengetahui sumbangan variabel tipe kepribadian dan tipe circadian terhadap sikap terhadap sistem kerja shift rotasi. Kemudian untuk menemukan perbedaan sikap terhadap sistem kerja shift rotasi antara dua kelompok kepribadian dan dua kelompok circadian dilakukan uji t. Dari penelitian ditemukan ada hubungan negatif yang signifikan antara tipe kepribadian dengan sikap terhadap sistem kerja shift rotasi. Semakin extravert kepribadian pekerja, semakin negatif sikapnya terhadap sistem kerja shift rotasi. Ditemukan juga hubungan yang negatif signifikan antara tipe circadian dengan sikap terhadap sistem kerja shift rotasi. Semakin siang tipe circadian pekerja, semakin negatif sikapnya terhadap kerja shift rotasi. Selain itu juga ditemukan adanya perbedaan sikap terhadap sistem kerja shift rotasi antara pekerja dengan kepribadian extravert dan pekerja dengan kepribadian introvert, serta pekerja dengan tipe circadian siang dan pekerja dengan tipe circadian malam. Saran yang dapat diajukan adalah perusahaan hendaknya memperhatikan faktor usia dan kecenderungan tipe circadian pekerja dalam menempatkan mereka pada kerja shift. Perusahaan juga hendaknya mengkaji kembali sistem kerja shift yang berlaku saat ini.

Abstrak :
ABSTRAK
Rumah sakit menyediakan pelayanan kesehatan selama 24 jam. Perawat sebagai bagian terpenting dari pelayanan kesehatan perlu memenuhi pelayanan 24 jam tersebut melalui kerja shift. Namun, perawat kerja shift lebih memiliki risiko penurunan kualitas tidur dibanding non-shift, yang dapat berdampak pada penurunan performa/kinerja. Penelitian ini untuk mengetahui perbedaan kualitas tidur antara perawat kerja shift dan non-shift. Desain penelitian ini adalah deskriptif komparatif dengan pendekatan potong lintang yang melibatkan 162 perawat di RSUD dr. H. Soemarno Sosroatmodjo Tanjung Selor, yang dipilih dengan proportional random sampling. Data demografi diambil melalui kuesioner A, kerja shift melalui kuesioner B dan kualitas tidur melalui kuesioner C The Pittsburgh Scale Quality Index. Hasil analisis statistik menunjukkan proporsi kualitas tidur buruk pada perawat yang bekerja shift 35.2 lebih tinggi dibandingkan pada perawat yang bekerja non-shift 10.5 . Analisis lebih lanjut menunjukkan bahwa terdapat perbedaan yang signifikan dalam kualitas tidur antara perawat yang bekerja shift dan non-shift x2 161 = 5.205; p = .023 Kesimpulan dalam penelitian ini terdapat perbedaan kualitas tidur antara perawat kerja shift dan non-shift di RSUD dr. H. Soemarno Sosroatmodjo Tanjung Selor. Saran bagi manajemen dan keperawatan rumah sakit, untuk membuat kebijakan pengaturan jadwal kerja yang meminimalkan penurunan kualitas tidur dan peningkatan kualitas tidur seperti kebijakan napping.

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ABSTRAK
Hospitals provide a 24 hour health services. Nurses as an integral part of health services at the hospital need to work in shifts in order to deliver uninterrupted nursing care. Nevertheless, shift work nurses have a higher risk of sleep deprivation than non shift, which may have an impact on performance degradation. This research aimed to identify the difference of sleep quality between shift and non shift work nurses. The design of this study was a comparative descriptive with cross sectional approach involving 162 nurses in RSUD dr. H. Soemarno Sosroatmodjo Tanjung Selor, selected by proportional random sampling. Demographic data were collected through questionnaire A, shift work through questionnaire B and sleep quality through Questionnaire C The Pittsburgh Scale Quality Index. The result of statistical analysis showed that the proportion of poor sleep quality in shift nurses 35.2 was higher than in non shift nurses 10.5 . Further analysis showed that there were significant differences in sleep quality between shift and non shift nurses x2 161 5.205 p .023 . Our study concluded the significant difference of sleep quality between shift and non shift working nurses at RSUD Tanjung Selor. This study suggested hospital and nursing management to create policy work schedule arrangements that could improve sleep quality. This study also suggested the development of policy with respect to napping for shift nurses.

Abstrak :
The increasing adaptation of shiftwork in the Philippines and its reported adverse effects had encouraged research studies among Filipino workers. This study aims to identify the circadian clock behavior of the shiftworker and its relationship together with the shift schedule against the level of performance. The subjects used in this study were call center agents. Subjects were initially asked to answer a compilation of survey from the Standard Shift work Index (SSI) and Swedish Occupational Fatigue Inventory (SOFI). During the experiment proper, three laptops with head microphones were used where each laptop contained the software and programs in measuring the speech ability, reaction time and memory of participants. Majority of the respondents belong to the morning type and only one belonged to the intermediate type. The General Health Score (SSI) of the agents was generally poor in the aspect of their psychological health. The Swedish Occupational Fatigue Inventory (SOFI) scores showed that the respondents did not experience excessive fatigue. Based on the two-way ANOVA, it was found that the three speech ability measures and reaction time were significant in terms of the performance deterioration at each schedule in relation to the body clock of the individual.