IntroductionThe COVID-19 pandemic has caused disruptions in educational institutions across the country, prompting medical schools to adopt online learning systems. This study aims to determine impact on medical education and the medical student’s attitude, practice, mental health after 1 year of the Covid-19 pandemic in Indonesia.MethodsThis study utilized a cross-sectional design. An online questionnaire was distributed digitally to 49 medical schools in Indonesia from February–May 2021. A total of 7,949 medical students participated in this study. Sampling was carried out based on a purposive technique whose inclusion criteria were active college students. This research used questionnaires distributed in online version among 49 medical faculties that belong to The Association of Indonesian Private Medical Faculty. Instruments included demographic database, medical education status, experience with medical tele-education, ownership types of electronic devices, availability of technologies, programs of education methods, career plans, attitudes toward pandemic, and the mental health of respondents. Univariate and bivariate statistical analysis was conducted to determine the association of variables. All statistical analyses using (IBM) SPSS version 22.0.ResultsMost of the respondents were female (69.4%), the mean age was 20.9 ± 2.1 years. More than half of the respondents (58.7%) reported that they have adequate skills in using digital devices. Most of them (74%) agreed that e-learning can be implemented in Indonesia. The infrastructure aspects that require attention are Internet access and the type of supporting devices. The pandemic also has an impact on the sustainability of the education program. It was found that 28.1% were experiencing financial problems, 2.1% postponed their education due to this problems. The delay of the education process was 32.6% and 47.5% delays in the clinical education phase. Around 4% student being sick, self-isolation and taking care sick family. the pandemic was found to affect students’ interests and future career plans (34%). The majority of students (52.2%) are concerned that the pandemic will limit their opportunities to become specialists. Nearly 40% of respondents expressed anxiety symptoms about a variety of issues for several days. About a third of respondents feel sad, depressed, and hopeless for a few days.ConclusionThe infrastructure and competency of its users are required for E-learning to be successful. The majority of medical students believe that e-learning can be adopted in Indonesia and that their capacity to use electronic devices is good. However, access to the internet remains a problem. On the other side, the pandemic has disrupted the education process and mental health, with fears of being infected with SARS-CoV-2, the loss of opportunities to apply for specialty training, and the potential for increased financial difficulties among medical students. Our findings can be used to assess the current educational process in medical schools and maximize e-learning as an alternative means of preparing doctors for the future.

Background Heart diseases are increasingly identified as an important indirect cause of maternal mortality in several cities in Indonesia. The management of pregnancy with heart diseases requires a multidisciplinary approach, and interprofessional collaboration practice (IPCP) is critical to improving the quality of patient care. To enable the effective implementation of IPCP, integrated care pathways (ICPs) are needed to define the roles and responsibilities of the health professionals involved. This study aims to examine the obstacles and enabling factors of IPCP, to develop and use ICPs in the implementation of IPCP in health care services for pregnant women with heart diseases. Methods A participatory action study consisting of four stages (diagnostic, planning, implementation, and evaluation) will take approximately 2 years after consensus of ICPs are made. The primary data collection process will employ consensus, observations, focus group discussions, and in-depth interviews throughout the four stages, while secondary data from referral documents and medical records will be collected mainly during the diagnostic and evaluation stages. The findings are being analysed and will then be used to develop an ICPs through consensus building at the planning stage to be applied in the implementation stage. Finally, the implementation outcome, including acceptability, adoption, appropriateness, and feasibility of IPCP, will be assessed in the evaluation stage. All qualitative data will be analysed thematically by two coders using NVIVO 12 software. Discussion This research aims to assess the needs of IPCP, develop and use the ICPs in the implementation of IPCP in health care services for pregnant women with heart diseases. Findings from this study will be used for health service planning and policy making to strengthen practice of IPCP during the referral process. As a result, pregnant women with heart disease will have better access to high-quality services at every health care facility to reduce maternal mortality. Trial registration Retrospectively registered in the ISRCTN registry with study ID ISRCTN82300061 on Feb 6, 2019.

Patient satisfaction is one of the health service quality indicators. The national health insurance, the quality in First Level Health Facilities (FKTP) is translated to Competence-Based Capitation indicators. This study aims to elaborate on the correlation between CBC Indicators and Patient Satisfaction at FKTP in Semarang City. A cross-sectional design with observational study was conducted from July to August 2019. According to CBC Data, indicators achievement involving Contact Rate (AK), Non-Specialist Referral Rate (RRnS), and Ratio of Chronic Disease Management Program Attendees (RPPB) were obtained from First Level Health Facility collaborated with Social Health Insurance Administration Body (BPJSK), (consisting of 2 Health Centers, 2 Physician Practices, and 2 Primary Clinics). Furthermore, Patients Satisfaction Data were gathered from 60 respondents, where every ten patients for each FKTP use questionnaire had validation test. Satisfaction Scale uses LIKERT with range 1 for very dissatisfi ed until 5 for very satisfi ed. The Mean of patient satisfaction toward health services at FKTP in Semarang City was Quite Satisfi ed (3,74), satisfaction dimensions lowest were tangible and assurance. The Spearman test results showed that AK was 0.038(p<0,05), RRnS was 0,651(p>0,05), and RPPB was 0,939(p>0,05). It concluded a correlation between the AK indicator and patient satisfaction, whereas RRnS and RPPB indicators were not correlated with patient satisfaction at FKTP in Semarang City. Attempts to increase the contact rate through a healthy contact are needed to improve the FKTPs CBC target achievement. Abstrak Kepuasan pasien merupakan salah satu indikator kualitas pelayanan kesehatan. Pada era jaminan kesehatannasional, kualitas pelayanan di Fasilitas Kesehatan Tingkat Pertama (FKTP) dinyatakan dalam indikator Kapitasi Berbasis Kompetensi (KBK). Penelitian ini bertujuan untuk mengetahui hubungan antara tingkat pencapaian indikator KBK dengan kepuasan pasien di FKTP di Kota Semarang. Penelitian observasional dengan rancangan cross sectional dilakukan pada bulan Juli sampai Agustus 2019. Data capaian KBK yang terdiri dari Angka Kontak(AK), Rasio Rujukan non Spesialistik (RRnS) dan Rasio Peserta Prolanis Berkunjung (RPPB) diperoleh dari FKTP mitra BPJS yang terdiri dari 2 Puskesmas, 2 Dokter praktik mandiri, dan 2 klinik pratama. Data kepuasan pasien diperoleh dari 60 responden (masing-masing 10 pasien dari setiap FKTP) menggunakan kuesioner yang sudah di uji validitasnya. Skala kepuasan menggunakan skala LIKERT dengan nilai antara 1 untuk sangat tidak puas sampai 5 untuk sangat puas. Rerata kepuasan pasien terhadap pelayanan di FKTP di Kota Semarang adalah cukup puas (3,74), aspek kepuasan terendah terletak pada dimensi tangible dan assurance. Berdasarkan uji korelasi Spearman didapatkan nilai p<0,05 (0,038) untuk angka kontak (AK), p>0,05 (0,651) untuk RRNS dan p>0,05 untuk (0,939) RPPB. Disimpulkan bahwa terdapat hubungan antara tingkat pencapaian indikator KBK pada indikator AK dengan kepuasan pasien di FKTP di Kota Semarang, sedangkan untuk indikator lain tidak berhubungan. Upaya peningkatan kontak sehat diperlukan untuk memperbaiki capaian target KBK di FKTP.

Background: Exposure to Ultraviolet B (UVB) rays on the skin causesmany problems, including pigmentation and aging effect. Hence, protection against it is needed. Purpose: The study aimedto determine the effect of corncob extract cream on the number of melanin pigments in guinea pig skins exposed to UVB rays. Methods: Anexperimental post-test-only control group study was conducted on the 25 guinea pigs. The guinea pigs were divided randomly into five groups: group I without cream, group II cream base, group III hydroquinone cream, group IV 30% corncob extract cream, and group V 40% corncob extract cream. The cream was given daily for 20 minutes before UVB exposure and 4 hours after UVB exposure. The total dose of UVB exposure was 780 mJ / cm2 for 28 days. The amount of melanin pigment was calculated using the CX21 image J. Result: The number of melanin pigment in groups I, II, III, IV, and V were 22.8±0.4 cells, 18±0.3 cells, 6.3±3.1 cells, 13.8±0.2 cells, and 9.4±0.5 cells, respectively. Asignificantlydifferent value of One way ANOVA test was <0.05. Thus, there was a difference in the number of melanin pigments between the five groups. LSD post-hoc test showed differences in each group (p <0.05). Conclusion: 40% corn cobs extract cream effectively decreased the number of melanin pigment in guinea pigs exposed to UVB rays.