Background: Chemotherapy affects the condition of cancer patients, physically, psychologically, socially and spiritually. The Self-care Symptom Management (SSM) program is a psychoeducation program with the goal of enhancing patients' self-care abilities to manage the side effects of chemotherapy, and thus improve the Quality of Life (QOL) of adult cancer patients and their family caregivers. The objective of the study is to determine the effects of the SSM program on the QOL of cancer patients undergoing chemotherapy and their family caregivers.Methods: The study adopts a quasi-experimental design, with one group and pre- and post-intervention tests. The study was conducted in a public hospital in Yogyakarta, Indonesia, with 40 cancer patients and 30 of their family caregivers. The QOL of patients is measured using the EORTC QLQ-C30, and for their family caregivers the CQOLC is used. Data analysis are carried out using a paired t-test and Wilcoxon test, with a 95% level of significance.Results: The data show significant differences between the mean scores on a single item of sleep disturbance (15.84 points) and a single item of financial difficulties (8.34 points) before and after the implementation of the SSM program. Clinical relevance is shown on a single item of sleep disturbance (≥10 points).Conclusions:The Self-care Symptom Management program represents a promising intervention to promote self-care management for cancer care in Indonesia.

Background: Elderly is an age group that is prone to sepsis and is sometimes difficult to enforce because signs of inflammation rarely appear. Procalcitonin is a specific marker for bacterial infection in the elderly and can be a sign of the severity of sepsis and can be used as a predictor of septic death in the elderly. The purpose of this study was to determine the relationship between procalcitonin levels and mortality in elderly septic patients. Methods: This study was an analytic observational study with a retrospective cohort design. Data were obtained from the patient's medical records. To analyze the sensitivity and specificity of procalcitonin values ​​in sepsis patients, statistical analysis of receiver-operating characteristics (ROC) curves was used with significant results if the ROC curve value was more than 50%. To determine the procalcitonin value with outcome, Chi-square test was performed. The data was processed with SPSS version 22.0. The test results are said to be meaningful if the p value <0.05. Results: The subjects of this study amounted to 52 people who met the inclusion and exclusion criteria. The median value of the age of the subjects was 66 (60-87) years with the most male subjects 51.92%. The diagnosis of severe sepsis was 48.08% followed by 29.62% sepsis and 25% septic shock. Subjects died as many as 27 subjects (51.92%). Hemoglobin level 11.3 g/dl; leukocytes 15.26.103/ml; platelets 150.103/ml and the value of procalcitonin 12.42 mcg/dl. The procalcitonin ROC curve showed that procalcitonin had a good predictor value (AUC 79.7%; p value 0.001), the procalcitonin value was 12.67 mcg/dl. Procalcitonin levels >12.67 mcg/dl died in 12 (75%) patients while elderly patients with procalcitonin levels <12.67 mcg/dl died in 6 (25%) patients. The chi-square test got a p value of 0.001 (RR 3 CI 95% 1.453-6.196). Conclusion: Procalcitonin is associated with mortality in elderly septic patients Keywords: Procalcitonin, Sepsis, elderly.

The ability of the Muslim community in Indonesia to perform the hajj pilgrimage, which fulfills Islam’s fifth pillar, is increasing. With the rise in life expectancy, the number of Indonesian elderly hajj pilgrims (EHP) is consequently growing. However, chronic conditions such as impairments, illnesses, and diseases cause an increase in morbidity and mortality among EHP. Thus, an innovative training program with practical tips for a healthy hajj experience is needed to improve the healthcare service to the EHP. This study aims to investigate the effects of an innovative training on the performance of Hajj Healthcare Workers of Indonesia (HHWI) and on the clinical outcomes of EHP. It was a quasi-experimental study. The population was all HHWI from the Surakarta embarkation in 2014. Meanwhile, the sample of this study was all 21 HHWI from Yogyakarta who received innovative training consisting of EHP special care training (theory and practice) in addition to basic national training. Twenty-one HHWI from Surakarta were randomly chosen as a control group and only received basic national training. Pre and post tests were used to assess knowledge of HHWI after training. The average pretest scores of the intervention and control groups were 48.50 and 48.07, respectively (p= 0.337), while the posttest score of the intervention group was 86.83 (p = 0.033). The measured parameters were the performance of HHWI, which is reflected by the EHP mortality rate, the number of outpatients, and the number of patients referred to the outpatients. We included the EHP under the supervision of HHWI, which has acquired training. EHP morbidity was evaluated as the number of outpatients and referred patients. There were 2216 outpatients from the intervention group as compared with 2144 in the control group, with most of them being 60-70 years old (p= 0,075). The number of referred EHP in the intervention and control groups was 10 and 30 patients, respectively (OR 2.94; p= 0.002). As for the mortality cases, we observed 7 EPH deaths during the hajj period (2 EPH from the intervention group vs 5 EPH from the control group; OR 0.263; p=0.207). Innovative training could reduce referral morbidity and mortality among elderly hajj pilgrims