Purpose In the Indonesian health‐care system, nurses and midwives often serve as the primary health‐care providers due to physician shortages. Seeking to address the need for medical care in resource‐limited environments, some have advocated for portable equipment in the hands of health‐care providers. We hypothesized that medical students are able to effectively teach point‐of‐care ultrasound (POCUS) to physicians, nurses, and midwives in rural Indonesia. Methods We conducted a prospective, observational study using health‐care practitioners from a clinic and accredited school for nursing and midwifery in Mojokerto, East Java, Indonesia. Enrolled practitioners took part in a 4‐week POCUS course followed by postinstructional testing. Results A total of 55 health‐care practitioners completed the course. This included 19 physicians, 13 nurses, and 19 midwives. Of the 55 clinicians, 43 (72%) passed the course and 12 (28%) failed. Conclusions Physicians, nurses, and midwives in rural Indonesia showed significant acquisition of ultrasound (US) knowledge and skills following a 4‐week US course. Following training, all three groups displayed skills in practical US use during a postcourse practical examination. This is one of the first studies to assess the efficacy of medical students teaching POCUS to midwives and nurses.

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Purpose - This article aims to give an opinion on the cause of still the case of pasung in Indonesia, physical restraint and reduction in people with mental illness (called pasung in indonesia), still found in indonesia, government program ” indonesia free of pasung” still can not erase indonesia from pasung. Design/methodology/approach -The approach to literature study causes the escape especially social stigma that occurs to make the case of the pipe still continues to exist Findings -The findings of many literature studies suggest that social stigma is a cause of social restraint in patients with severe psychiatric disorders Originality/value -The value of this study envolve Empowering people with mental disorders through social intervention can reduce the side effects of antipsychotic drugs and simultaneously help self-stigma in people with mental disorders

Purpose - This article aims to give an opinion on the cause of still the case of pasung in Indonesia, physical restraint and reduction in people with mental illness (called pasung in indonesia), still found in indonesia, government program ” indonesia free of pasung” still can not erase indonesia from pasung. Design/methodology/approach -The approach to literature study causes the escape especially social stigma that occurs to make the case of the pipe still continues to exist Findings -The findings of many literature studies suggest that social stigma is a cause of social restraint in patients with severe psychiatric disorders Originality/value -The value of this study envolve Empowering people with mental disorders through social intervention can reduce the side effects of antipsychotic drugs and simultaneously help self-stigma in people with mental disorders

Purpose The purpose of this paper is to illustrate delirium as a possible consequence of the application of symptom-triggered therapy for alcohol withdrawal and to explore alternative treatment modalities. In the management of alcohol withdrawal syndrome, symptom-triggered therapy directs nursing staff to regularly assess patients using standardized instruments, such as the Clinical Institute for Withdrawal Assessment of Alcohol, Revised (CIWA-Ar), and administer benzodiazepines at symptom severity thresholds. Symptom-triggered therapy has been shown to lower total benzodiazepine dosage and treatment duration relative to fixed dosage tapers (Daeppen et al., 2002). However, CIWA-Ar has important limitations. Because of its reliance on patient reporting, it is inappropriate for nonverbal patients, non-English speakers (in the absence of readily available translators) and patients in confusional states including delirium and psychosis. Importantly, it also relies on the appropriate selection of patients and considering alternate etiologies for signs and symptoms also associated with alcohol withdrawal. Design/methodology/approach The authors report a case of a 47-year-old male admitted for cardiac arrest because of benzodiazepine and alcohol overdose who developed worsening delirium on CIWA-Ar protocol. Findings While symptom-triggered therapy through instruments such as the CIWA-Ar protocol has shown to lower total benzodiazepine dosage and treatment duration in patients in alcohol withdrawal, over-reliance on such tools may also lead providers to overlook other causes of delirium. Originality/value This case illustrates the necessity for providers to consider using other available assessment and treatment options including objective alcohol withdrawal scales, fixed benzodiazepine dosage tapers and even antiepileptic medications in select patients.