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Abstrak :
Lansia dengan demensia dapat menjadi beban bagi keluarga. Mengenal faktor risiko demensia dapat mencegah perburukan Intervensi keperawatan keluarga melalui aplikasi android pada era digital sangatlah penting untuk meningkatkan kemampuan koping keluarga dalam merawat lansia. Tujuan penelitian adalah memperoleh model keperawatan Keluarga Peduli Demensia – Raden Siti Maryam (KEDUSIA-RSM) berbasis android yang efektif untuk meningkatkan kemampuan keluarga, kepuasan keluarga, fungsi kognitif dan pengendalian faktor risiko demensia pada lansia serta menurunkan beban merawat keluarga. Penelitian ini menggunakan desain riset operasional melalui 2 tahapan yaitu Tahap 1 : pengembangan model hasil integrasi antara studi pendahuluan, studi literatur dan konsultasi pakar dan Tahap 2 : uji coba model dengan desain pre dan post tes dengan kelompok kontrol. Strategi pengambilan sampel menggunakan kluster gugus bertahap dengan jumlah sampel sebanyak 156 yaitu 79 keluarga kelompok intervensi dan 77 keluarga kelompok kontrol. Hasil penelitian diperoleh: 1) Tahap I dihasilkan model keperawatan KEDUSIA-RSM berbasis android, buku pegangan untuk keluarga dan aplikasi android KEDUSIA-RSM; 2) Tahap II : terdapat perbedaan bermakna rerata kemampuan merawat keluarga (pengetahuan, sikap, keterampilan) dan kepuasan merawat antar pengukuran (sebelum, 2 bulan dan 4 bulan setelah intervensi model) pada kelompok intervensi (p value < 0,05; repeated measure ANOVA); terdapat perbedaan bermakna rerata fungsi kognitif dan pengendalian faktor risiko demensia antara kedua kelompok pada pengukuran sebelum dan sesudah 4 bulan (p value < 0,05; uji t dua sampel bebas). Kesimpulan: model keperawatan KEDUSIA-RSM efektif meningkatkan kemampuan, kepuasan merawat, fungsi kognitif dan pengendalian faktor risiko demensia lansia serta menurunkan beban merawat keluarga. Rekomendasi: 1) Replikasi model 2) Pelatihan berkelanjutan bagi perawat Puskesmas, kader lansia, dan keluarga 3) Penelitian lanjutan yaitu pengembangan aplikasi berbasis iOS atau web. ......Elderly people with dementia can be a burden to the family. Recognizing risk factors for dementia can prevent progressifity. Family nursing interventions through android applications in the digital era are very important to improve family coping skills in caring for elderly with dementia risk factors. The research objective was to obtain an android-based model of KEDUSIA-RSM which is effective for improving family ability, family satisfaction, cognitive function and controlling for dementia risk factors in the elderly, and decrease caregiver burden. This study uses an operational research design through 2 stages, namely Stage 1: the development of the integration result model between the preliminary study, literature study and expert consultation and Phase 2: the model trial with the pre and post test design with the control group. The sampling strategy used a multistage cluster with a total sample size of 156, namely 79 families in the intervention group and 77 families in the control group. The results of the research were: 1) Phase I produced application based KEDUSIA-RSM nursing model, handbook for family and its application; 2) Phase II: there is a significant difference in the average ability to care for the family (knowledge, attitudes, skills) and care satisfaction between measurements (before, 2 months and 4 months after the model intervention) in the intervention group (p value <0.05; repeated measure ANOVA) There was a significant difference in the mean cognitive function of the elderly and controlling risk factors for dementia between the two groups in the measurement before and after 4 months (p value <0.05; independent t-test). Conclusion: The KEDUSIA-RSM nursing model is effective in increasing the ability to care for and satisfaction in caring as well as improving cognitive function and controlling risk factors for dementia in the elderly. Recommendations: 1) Model replication; 2) Continuous training and assistance for puskesmas nurse, elderly cadres, and family caregiver; 3) Further research, namely web/ iOS-based application development.

Abstrak :
Inflamasi kronik adalah proses yang penting dalam patofisiologi adenokarsinoma duktal pankreas (PDAC). Beberapa studi telah meneliti potensi enzim siklooksigenase-2 (COX-2) sebagai faktor prognostik PDAC, dengan hasil yang kontradiktif. Nuclear factor kappa−B (NF−?B), specificity protein 1 (Sp1), dan c−Jun adalah faktor transkripsi gen COX2. Penelitian ini adalah studi observasional eksploratori yang bertujuan untuk mengidentifikasi asosiasi ekspresi protein NF−?B (RelA/ p65), COX−2, Sp1, dan c−Jun dengan kesintasan pasien PDAC. Ekspresi protein tersebut dinilai di jaringan pasien PDAC menggunakan metode imunohistokimia. Diidentifikasi ekspresi keempat protein tersebut dengan overall survival (OS) dan karakteristik klinikopatologis pasien PDAC. Sebanyak 53 jaringan PDAC dari biopsi atau reseksi kanker diikutkan dalam penelitian. Hasilnya terdapat korelasi antara keempat protein di jaringan kanker. Ekspresi NF−?B sitoplasmik (aHR = 0.31; 95% CI 0.11–0.90; p = 0.032) atau nuklear (aHR = 0.22; 95% CI 0.07–0.66; p = 0.007) berhubungan secara independen dengan prognosis pasien yang lebih baik. Protein lainnya tidak berhubungan dengan kesintasan pasien. Hal ini menunjukkan bahwa peran inflamasi di PDAC lebih kompleks dari yang diperkirakan sebelumnya. ......Chronic inflammation is a crucial driver of carcinogenesis in pancreatic ductal adenocarcinoma (PDAC). Several studies have investigated the prognostic significance of cyclooxygenase−2 (COX−2) expression in PDAC patients, obtaining conflicting results. Nuclear factor kappa−B (NF−?B), specificity protein 1 (Sp1), and c−Jun are known as the transcription factors of the COX2 gene. This exploratory observational study investigated the association of the NF−?B, COX−2, Sp1, and c−Jun expressions with patient survival in PDAC. We used the immunohistochemical method to detect the PDAC tissue expressions of NF−?B (RelA/p65), COX−2, Sp1, and c−Jun. The expressions of these proteins were correlated with the overall survival (OS) and other clinicopathological characteristics of PDAC patients. We obtained 53 PDAC specimens from resections and biopsies. There were significant correlations between the four proteins’ expressions in the PDAC tissues. The expression of the cytoplasmic (aHR = 0.31; 95% CI 0.11–0.90; p = 0.032) or nuclear NF−?B (aHR = 0.22; 95% CI 0.07–0.66; p = 0.007) was independently associated with a better prognosis in the PDAC patients. COX−2, Sp1, and c−Jun showed no significant association with a prognosis in the PDAC patients. The PDAC patients who expressed NF−?B had a better prognosis than the other patients, which suggests that the role of inflammation in PDAC is more complex than previously thought.