International Conference on Pharmaceutical, Medical, and Health Sciences

(ICPMHS 2013)

November, 4-5, 2013

Kasetsart University, Bangkok, Thailand

Organized by
Indonesian Student Association in Thailand (PERMITHA)

Co-organized by
International Studies Center, Kasetsart University, Thailand
Faculty of Agriculture, Kasetsart University, Thailand

Co-sponsored by
Embassy of the Republic of Indonesia in Bangkok

International Scientific Reviewers

Prof. Takayuki Kageyama (Oita Unversity of Nursing and Health Sciences, Japan)
Prof. Edi Dharmana (Diponegoro University, Indonesia)
drg. Zahroh S, MPH, PhD (Diponegoro University, Indonesia)
Anchaleeporn Amatayakul RN., PhD (Boromarajonani College of Nursing, Thailand)
Dr. Kamolrat Tumer (Boromarajonani College of Nursing, Thailand)

Editor
Reynaldo Siahaan
Canggih Puspo Wibowo

Illustrator
Bryan Octavianus

© 2013 Indonesian Student Association in Thailand (PERMITHA)

All rights reserved. Abstracting is permitted with credit to the source.
 

  i 
 PREFACE

On behalf of the Organizing Committee of the 2nd ASEAN Academic Society International
Conference (AASIC), it is an honor to welcome you all to the International Conference on
Pharmaceutical, Medical, and Health Sciences (ICPMHS 2013). The main conference, the 2nd
AASIC, consists of a keynote speech, plenary speeches, and also parallel presentations which
focus on medical and health sciences as well as related fields.

The 2nd ASEAN Academic Society International Conference having a theme of “Passage
Towards ASEAN Community 2015: Bridging Science, Technology and Humanities” consists
of three International Conferences of which one of them is ICPMHS 2013. The theme
stresses on bridging of all community of experts in research and innovation in facing of
ASEAN Community 2015. All papers submitted to the 2nd AASIC have been reviewed by
more than 15 international scientific committee members from over 10 different countries
ensuring the quality of the accepted papers.

The ICPMHS 2013 is organized by Indonesian Student Association in Thailand, in

cooperation with the International Studies Center and Faculty of Agriculture of Kasetsart
University, with a partial financial sponsorship by the Embassy of The Republic of Indonesia
in Bangkok. I would like to express my deep gratitude to above mentioned organizations that
made the conference possible. In addition, I would like also to thank all International
Scientific Committee for assisting the Organizing Committee to review papers submitted to
the conference. This conference will not be possible without the participation of the authors,
to whom I would like to express my thankfulness.

Last but not least, I would like to thank all of you for coming and wish you a pleasant stay in
Bangkok and a fruitful conference.

Canggih Puspo Wibowo

Chairman of 2nd AASIC
 

  ii 
Advisory Board Committee
Education Section, Embassy of the Republic of Indonesia
International Studies Center, Kasetsart University
Indonesian Student Association in Thailand

Organizing Committee
Chairman : Canggih Puspo Wibowo
Secretary : Reynaldo Siahaan
Treasurer : Silvy Astari
Yulia Tri Mardani

Local Scientific : Yeni Lufiana Novita Agnes

Committee Sri Wahyuni
Saparila Worokinasih
Heru Herlambang
Nurrohman Wijaya
Laura Ruslan

Registration : Megah Andriany

Jenny Marlindawany
Putri Mayasari
Desmawati

Protocol and : Sukardin

Reception Erika
Bayu Mitra Adhyatma Kusuma
Akiko Nada Atsmara

Gala Dinner : Ariz Qillah

Go Peter Christian
Fathia Mahmuda

Logistic : Khoirul Anam

Delly Arfa Syukrowardi
Henny Sutriyawati
Kurnia Latifatul Insaning Azizah
Umi Retnoningrum
Ilman Nafi
Hendri Irawan
Zulham Suhanda
Mohammad Syaiful Anwar
Dhinasty Swaka Pax Humanica
Tuti Hayati
Riki Apriansyah

Accommodation : Yoski
Ahmad Satria Budiman

Documentation : Amin Fatoni

  iii 
 Aldian Farabi
Fauzan Romadlon
Faishal Mufied al Anshary
Nurulistyawan Tripurnanto

Multimedia : Bryan Octavianus Augustus

Muhammad Khoirul Hasin

  iv 
  

TABLE OF CONTENT

Title Page i
Preface ii
Organizing Committee iii
Table of Content v

1 The Worth of Forensic Psychology: A Review of the BRACE Character 1

Profile as Prospects of Criminal Profiling
Nur Lailatul MASRUROH and Ingga Yonico MARTATINO

2 Knowledge, Attitude, and Practice of Prisoners’ Oral Health Care Aged 4

35-44 Years in Prison of Class II B Garut
Muhammad Boggi RISWANTO, Anne AGUSTINA and Riana
WARDANI

3 Household Contact Of Pulmonary Tuberculosis In Wonogiri District, 7

Central Java Province, Indonesia
Lintang Dian SARASWATI, Praba GINANDJAR and Wiwin
ANDRIYANI

4 Posyandu On The Road 10

Tiffany Nisa ARVIYANI, Karera ARYATIKA and Ega SURYADIANA

5 The Potential Hypnotherapy to Reduce Frequency of Enuresis in Children 13

Preschool on Baturraden
Salfiyah SUGIRI, Sri Aprina SIREGAR and Puspita ANINDA

6 Relationship between Demographic Characteristics, Knowledge, 16

Expression Emotion and Burden of Family Caregiver of Patients with
Schizophrenia
Alit ADIANTA, Susheewa WICHAIKUL and Sukjai CHAROENSUK

7 The Relationship among Socio-demographic Characteristics, Structural 20

Empowerment, and Job Satisfaction of Community Health Volunteers in
Indonesia
I Gusti Ngurah Made KUSUMA NEGARA, Anchaleeporn
AMATAYAKUL and Monthana HEMCHAYAT

  v 
  

8 The Effect of a Family Psycho-education Program on Family Caregivers' 24

Attitude to Care for Patients with Schizophrenia
I Gusti Ayu Rai RAHAYUNI, Susheewa WICHAIKULL and Sukjai
CHAROENSUK

9 Factors Associated with Psychological Impact of Junior High School 28

Students after Earthquake in Padang, West Sumatera, Indonesia
Milya NOVERA, Kanokwan WETASIN and Wilaiporn KHAMWONG

10 A Finding Analysis of Tuberculosis Suspect Case In Community 32

AGRINA

11 Relationships among Gender, Perception, Knowledge, Stigma, and 35

Duration of Treatment Seeking Behavior Pulmonary Tuberculosis Patients
in Indonesia
Madyo MARYOTO, Anchaleeporn AMATAYAKUL and Monthana
HEMCHAYAT

12 Involvement of Cholinergic System in Alcohol Dependence Behavior 39

Ridho ISLAMIE, Kusnandar ANGGADIREDJA and Stefany F.A.

HERNANDEZ
13 A Tentative Model of Transaction Care for Prisoners with TB 43

Megah ANDRIANY

14 Health Psychology of Key to Sustaining and Thriving of Human Well 47

Being: Self Control, Conscientiousness, and Adverse Health Behavior
Nur Lailatul MASRUROH and Ingga Yonico MARTATINO

15 Relationship between Self Efficacy of Health Promotion Lifestyle and 51

Social Support of High School Student
Dona Yanuar AGUS SANTOSO, Anchaleeporn AMATAYAKUL and
Benjamas SIRIKAMONSATHIAN
16 The Prevalence and Risk Factors of Hypertension of Rural Population in 55
Yogyakarta, Indonesia: A Cross-Sectional Study

Ayyu SANDHI, Vivi Leona AMELIA and Nurul Maliki RAYUN ITTAQ

17 Anticancer activity of Bruceine A isolated from the seeds of Brucea 59

javanica on Hela cell

Dwi SUTININGSIH and Susiana PURWANTISARI

  vi 
  

18 The in-vitro Antioxidant Activity of n-Hexane Extract of Jatropha curcas L. 62

leaf
NURLELY, Srichan PHORNCHIRASILP, Rungravi TEMSIRIRIRKKUL
and Yuvadee WONGKRAJANG
19 Suspect Detection and Active Case Finding are Important in Increasing 67
Case Detection Rate (CDR): a Comparison in High and Low Tuberculosis
CDR areas
Praba GINANDJAR, Lintang Dian SARASWATI and Ermayani DWI
ASTUTI
20 Physiological and Psychological Benefits of Therapeutic Storytelling to 71
Inpatient Children
Arie KUSUMANINGRUM, Evy Anggraini GULTOM and Nia RISA
DEWI

21 High Blood Pressure Medication Management: a Qualitative Study on 75

Hypertensive Patients in Pacitan, East Java, Indonesia
Dewi UTARI, Sunanta THONGPHAT and Boosaba SAGUANPRASIT

22 Cytotoxic Effects Of Methanol Extracts Of Soursop Leaves (Annona 79

muricata) On Mcf-7 Cell Line And Its Effect On Expression Of Bcl-2
Protein
Eka Prasasti NUR RACHMANI, Tuti SRI SUHESTI, Retno WIDIASTUTI
and Aditiyono ADITIYONO

23 Prevalence And Determinant Of Maternal Near Miss In Indonesia 83

Rini MUTAHAR, Suci DESTRITANIA and Sindu SETIA

24 The Effect of Exercise Consultation Program on Exercise Behavior Change 87

and Self-efficacy to Regular Exercise in Patients with Type 2 Diabetes
Rinco SIREGAR, Sunanta THONGPAT and Boontuan WATTANAKUL

25 Modification OVITRAP To Control Of Aedes spp Population In Central 91

Java
MARTINI, Anggit PRIHATNOLO and Retno HESTININGSIH

26 Factors Influencing Relapse in People with Mental Disorder in Indonesia 95

Ade SRYWAHYUNI

  vii 
  

27 Anti-Fatigue Activity of Honey From Apis mellifera, Apis cerana, and 99

Trigona sp in Mice
Mukti PRIASTOMO

28 Safe Sex Behavior For HIV/AIDS Prevention Among Married Women 103

Yeni AGNES

29 Bullying Term of Groups and Gender in Adolescents 107

Susi MURYANI, Sunanta THONGPAT

  viii 
 The Worth of Forensic Psychology: A Review of
the BRACE Character Profile as Prospects of
Criminal Profiling
1)2) 3) 4)5) 6)7) 8)
Nur Lailatul Masruroh , D. Candra Purnama , Ingga Yonico Martatino , Andri Frediansyah , Fitria Dini
1
Muhammadiyah University of Malang, Indonesia
2
Master of Nursing Science, Graduate School of Kasetsart University, Bangkok 10900, Thailand
Email: faranurlailatul@yahoo.com
3
Forensic Division, State Police Department, Republic of Indonesia
4
Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia
5
Department of Psychology, State Islamic University of Sunan Kalijaga Yogyakarta, Indonesia
6
Chulabhorn Graduate Institute, Bangkok, Thailand
7
Indonesian Institute of Sciences (LIPI), Indonesia
8
Medical Faculty of Wijaya Kusuma, Surabaya, Indonesia
Abstract— This paper showed that a prospects of criminal accuracy of BRACE, which is compared to published
profiling based critical review of the BRACE character profile averages achieved with traditional profiling methods, and high
because potential of violent and serial crime is a growing concern light the potential applications and focus areas for future
in Indonesia and elsewhere. The BRACE Character Profile is a study[3]. It has a powerful analytical tool that is designed to
powerful analytical tool that is designed to profile the core human profile the core human nature of a known or unknown subject
nature of a known or unknown subject (UNSUB), and provides (UNSUB), and provides a rich narrative of a subject’s profile
a rich narrative of a subject’s profile across three domains, across three domains, namely cognitive, behavioral, and
namely cognitive, behavioral, and existential motivational. existential motivational [4]. The ways a person thinks, desires,
The objectives of the current study are to briefly address the and acts are reflected in graphical format and interpreted in a
potential of offender profiling and current shortcomings, systematic manner that are structured according to the
introduce the BRACE Character Profile instrument, and prototypical personality disorder types of the DSM IV-TR [5].
explain the rationale and basic methodology. A common
criticism that can be addressed by the BRACE II. MATERIALS AND METHODS
®
methodology is the reported lack of scientific grounding, The BRACE Character Profile input form consists of 75
empirically evidence, and standardization of narrative type vignette like questions designed to rate behavioral aspects of a
profiles, and the “one size fits all” approach of actuarial know or unknown subject in terms of severity and role in the
profiling methods. The methodology has had exposure in core character [6]. The questions are clustered in matrix
forensic scale activities of UNSUB profiling, psychological format across three core character types, namely Types A, B,
autopsies, cold case reviews, interrogation strategy, risk of and C, and three domains of eight or nine variables each,
violence determination, and defense or prosecutor strategy, but namely cognitive, behavioral, and existential [7].
the need to qualify the usefulness in each area has to be addressed The methodology has had exposure in forensic scale activities
to ensure practical effectiveness and evidentiary acceptability, of UNSUB profiling, psychological autopsies, cold case reviews,
and entrench the methodology more widely. interrogation strategy [8]. By referencing the strength of scores
related to their type domain characteristics, the likely triggers
Keywords—forensic psychology; BRACE measurement; criminal and expressions of maladaptive behavior is identified, which
profiling can be applied to a variety of settings and objectives [9]. The
matrix structure and associated characteristics are illustrated
I. INTRODUCTION in table 1 below.
The prevalence of violent and serial crime is a growing
concern in Indonesia and elsewhere. Despite the widespread
use of criminal profiling in serial crime investigations, the
practice continues to endure fierce criticism from researchers,
who almost unanimously agree that profiling lacks scientific
foundation and depends on flawed methodology [1]. As a
result the validity and utility of criminal profiling is
compromised to the extent where evidence is not admissible in
court, and serious miscarriages of justice are caused. The
challenge therefore exists to establish an empirically credible
instrument to standardize and benchmark behavioral profiles
[2].
Current study are to briefly address the potential of
offender profiling and current shortcomings, introduce the
BRACE Character Profile instrument, and explain the
rationale and basic methodology, establish independent

1
 TABLE I. MATRIX STRUCTURE [7].
The questionnaire results are processed in an Microsoft
Excel based macro and portrayed visually in a graphical
presentation supplemented by detailed scores that indicate the
presence or absence of prominent features at each matrix cross-
section. A quick visual comparison of the subject profile is
presented with the ten personality disorders specified in the DSM
IV-TR. A typical graphical presentation of the results is
illustrated in table 2 below.
TABLE II: GRAPHICAL OVERVIEW
PRESENTATION OF BRACE CHARACTER
PROFILE RESULTS [8]
Another useful feature of the BRACE Character Profile is
that the questionnaire input and profile interpretation tasks
may be done by different parties, including teams, which
implies that the data capture, who is typically an investigator
in criminal settings, does not require specialized nor
psychological training [10]. For the purpose of establishing
the validity and utility of the BRACE Character Profile four
question sets have been completed with the subject identity
not revealed. These were analyzed and interpreted, and after
the subject identities were made known, the statements that
made up the behavioral profile were compared to available
information about the real subject identity.
III. DISCUSSION
The results that were achieved with the BRACE Character
Profile is presented in Diagram 3 and compared with
published benchmarks that mostly examined traditional
narrative type or actuarial profiles.
Table III: BRACE Character Profile Accuracy Results
The subject identities are not revealed in publication, as
the inmate population in Indonesia are classified as a
vulnerable population of particular note is that statements that
were deemed as not accurate in these benchmark studies were
mostly entirely incorrect or misleading, compared to no
statements that were found to be incorrect in any of the
BRACE profiles, but only partially correct, which was mainly
due to a lack of information to confirm accuracy [11,12].
Therefore, in terms of accuracy the BRACE Character Profile
instrument has promising potential to be developed as part of
a standard and scientifically accepted process of criminal
profiling.
The limitations of the current study are availability of a
limited data sample, the setup did not test inter rater
reliability, the potential effects of interpreter variability
remain unknown, and the comparison between profile
elements and real subject characteristics were done quality.
Despite the promising results regarding profile accuracy, the
utility or usefulness of the BRACE Character Profile
methodology has to be established across the range of
potential applications.
2
 IV. CONCLUSIONS
The BRACE questionnaire takes upwards of 30 minutes to
complete depending on the needs of additional information,
and demands an intimate, in depth knowledge of the subject's
behavioral traits and want acts dynamics, which is useful for
knowledge sharing and strategy planning in an investigative
team. The current study establishes the accuracy and validity
of the BRACE methodology, but utility and cost benefit ratio
has to be examined in practice across the various potential
applications.
A common criticism that can be addressed by the BRACE
methodology is the reported lack of scientific grounding,
empirically, evidence, and standardization of narrative type
profile, and “the one size fits all” approach of actuarial
profiling method. The BRACE methodology has had exposure
in forensic activities of UNSUB profiling, psychological
autopsies, cold case reviews, interrogation strategy, risk of
violence determination, and defence or prosecutor strategy,
but the need to qualify the usefulness in each area has to be
addressed to ensure practical effectiveness and evidentiary
acceptability, and entrench the methodology more widely.

REFERENCE

1. L. Alison, M.D. Smith, and K. Morgan, “Interpreting the accuracy of

offender profiles,” Psychology, Crime & Law., 9(2), 185-195.
doi:10.1080/1068316031000116274, 2003.
2. American Psychiatric Association. Diagnostic and statistical manual
of mental disorders. Clinical Psychology: New York. 2009.
3. C. Dowden, C. Bennell, and S. Bloomfield, “Advances in offender
profiling: A systematic review of the profiling literature published
over the past three decades,” Journal of Police and Criminal
Psychology., 22, 44-56. doi:10.1007/s11896-007-9000-9. 2007.
4. C. Broman, ”The Longitudinal Impact of Adolescent Drug Use on
Socioeconomic Outcomes in Young Adulthood,” Journal of Child &
Adolescent Substance Abuse., 18(2), 131-143. Retrieved from ERIC
database, 2009.
5. DSM-IV-TR. Washington,DC; Author doi: 10.
1176/appi.books970890423349. 2000.
6. B.E. Harcourt, Against prediction: Profiling, policing, and punishing
in an actuarial age. Chica-go, IL: The University of Chicago Press,
2007.
7. W. Petherick, The fallacy of accuracy in criminal profiling. In Serial
crime: Theoretical and practical issues in behavioral profiling, 2009.
pp. 53-64.
8. M.A. Burlington, “A validity test of the BRACE Character Profile,“
The Master's Advocate., Elsevier Academic Press. Smith, R. L.
15(2), 11-12, 2008.
9. R.N. Kocsis, Smoke and mirrors: The illusions of accuracy in
criminal profiles. In Criminal profiling: Principles and practice.
Totowa, NJ: Humana Press, 2006. pp. 13-26.
10. Associated Press [AP](2010). Obesity costs U.S. $168 billion, study
finds. USA Today. Retrieved October 20, 2010. [Online]. Available:
http://www.usatoday.com/ yourlife/fitness/2010-10-18-obesity-
costs_N.htm?loc=interstitialskip.
11. J. Asendorpf, P. Borkenau, F. Ostendorf, and Van Aken, M,
“Carving per-sonality description at its joints: Confirmation of three
replicable personality prototypes for both children and adults,”
European Journal of Personality, 15(3), 169-198. Retrieved June 19,
2009, doi:10.1002/per.408, May, 2001.
12. C. Braet, L. Claus, S. Verbeken, and L. Van Vlierberghe,
“Impulsivity in overweight children,” European Child & Adolescent
Psychiatry., 16(8), 473-483. doi:10.1007/s00787-007-0623-2, 2007.

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 Posyandu on the Road
Tiffany Nisa Arviyani 1, Karera Aryatika 2, and Ega Suryadiana 3
1
Departement of Community Nutrition, Faculty of Human Ecology, Bogor Agricultural University
Bogor 16680, Indonesia
Email: fanie_cheer@yahoo.com
2
Departement of Community Nutrition, Faculty of Human Ecology, Bogor Agricultural University
Bogor 16680, Indonesia
Email: karera.aryatika@yahoo.co.id
3
Departement of Community Nutrition, Faculty of Human Ecology, Bogor Agricultural University
Bogor 16680, Indonesia
Email: egasuryadiana@rocketmail.com

Abstract— Health is a basic right for every human being
from the age of infants, toddlers, teens, adults to old age as
stated in the Constitution of the Republic of Indonesia
1945 section 28H paragraph 1 (UUD RI 1945 pasal 28H
ayat 1) and also as an investment, so it needs to be pursued
and enhanced by each individual, in order to achieve an
optimal level of public health. One form of community
empowerment efforts in the health sector is to develop
Posyandu. Posyandu (Pos Pelayanan Terpadu) is a
container-managed public health services and hosted
from, by, for, and with the community with support
services and technical guidance from health professionals,
which aims to develop human resources.
Community awareness nutrition and health still lack,
especially to the rural communities. Most mothers of
infants and toddlers lazy to bring them to the Posyandu, as
well as pregnant women. Posyandu on the Road is one of
the solutions to overcome the problem of lazy mothers who
come to the Posyandu. Posyandu on the Road carried from
door to door that meaning volunteers and health workers
visited one of the houses that have infants, toddlers, and
pregnant women. Posyandu on the Road have the same
activity with regular Posyandu. Difference of Posyandu on
the Road with normal Posyandu lies in the place, where
Posyandu on the Road using the car, while the regular
Posyandu held in resident’s  house or in the village hall.
Posyandu on the Road is expected to contribute to
improving the quality of human resources that will be the
potential for the development of the nation's health.
Keywords— posyandu; healthcare of mother and infant;
pregnant women
I. INTRODUCTION
Health is a basic right for every human being from the age
of infants, toddlers, teens, adults to old age as stated in the
Constitution of the Republic of Indonesia 1945 section 28H
paragraph 1 (UUD RI 1945 pasal 28H ayat 1) and also as an
investment, so it needs to be pursued and enhanced by each
individual, in order to achieve an optimal level of public
health. One form of community empowerment efforts in the
health sector is to develop Posyandu [1].
Posyandu (Pos Pelayanan Terpadu) is a container-
managed public health services and hosted from, by, for, and
with the community with support services and technical
guidance from health professionals, which aims to develop
human resources.The main objectives of Posyandu are to
support the acceleration of the decline Maternal Mortality
Rate (MMR), Infant Mortality Rate (IMR) and Child
Mortality Toddler in Indonesia through community
empowerment. Posyandu target is the whole society,
especially infants, toddlers, pregnant women, new mothers,
nursing mothers, and couples of childbearing age. However,
the main target is the Posyandu are infants, toddlers, and
pregnant women, because of that groups is the vulnerable
groups of nutrition. Posyandu was held in each village that is
only once a month and can be done in one of the residents’s 
house, courtyard houses, village hall, one of the market stalls,
one of the room office, or a special place that was built in by
the community [1].
Community awareness nutrition and health still lack,
especially to the rural communities. Most mothers of infants
and toddlers lazy to bring them to the Posyandu, as well as
pregnant women. There are several reasons they are lazy come
to Posyandu, such as their house far from Posyandu, busy
working or busy doing homework and others. This happens
due to ignorance of the community on the benefits of
Posyandu, such as providing basic health information and
services related to the decline in MMR, IMR, and Child
Mortality Toddler. In addition, people can also get a
professional service in solving problems related to health,
especially maternal and child health. Specifically, benefits of
Posyandu for infants are undernourished, poor nutrition, or
other abnormalities in infants and toddlers can be detected
early, so that prevention and treatment more quickly and
precisely. For pregnant women, pregnancy abnormalities can
also be detected early and fetal development can be controlled
every month. If detected abnormalities in infants, toddlers,
and pregnant women, it is immediately referred to the
Puskesmas (Puskesmas) or Community Health Centers.
Therefore, Posyandu on the road is one of the solutions to
overcome the problem of lazy mothers who come to the
Posyandu. Posyandu on the Road carried from door to door
that meaning volunteers and health workers visited one by one
of the houses that have infants, toddlers, and pregnant women.

10
Posyandu on the Road have the same activity with regular
Posyandu, including infants and toddlers weighing, giving of
vitamins for infants, toddlers, and pregnant women, pregnant
women pregnancy consultation with health workers, as well as
nutritional and health counseling. Posyandu on the Road is
expected to improve nutrition and public health.
II. DISCUSSION
Posyandu is a container-managed public health services
and hosted from, by, for, and with the community with
support services and technical guidance from health
professionals, which aims to develop human resources.
Manager of Posyandu is a “kader”  or  volunteers  who are
members of the community who are willing, able, and have
the time to organize Posyandu activities. Posyandu also
involve health workers who can provide medical services to
the community. Volunteers are carrying out the task of
weighing infants, toddlers, and pregnant women then record
the weighing results in the book of KIA (Kesehatan Ibu dan
Anak) or mother and child health and KMS (Kartu Menuju
Sehat) or health card and fill Posyandu’s register book, as well
as measuring LILA (Lingkar Lengan Atas) or upper arm
circumference in the mother pregnant. In addition, volunteers
are also mandated to implement nutrition and health education
activities and provide PMT (Pemberian Makanan Tambahan)
or supplementary feeding for toddlers. Posyandu is held in
every village at least once a month and can be done in one of
the houses, courtyard houses, village hall, one of the market
stalls, one of the room offices, or a special place that was built
in by the community [1].
The benefits of Posyandu such as, for the community is
that to provide information and basic health services,
especially related to the decline in MMR, IMR, and Child
Mortality Toddler and provide services in a professional
manner in solving problems related to health, especially
maternal and child health. Meanwhile, the benefits of
Posyandu for volunteers, health workers, and community
leaders is that they get information in advance about health
efforts related to reducing MMR, IMR, and Child Mortality
Toddler and they can realize self-actualization in helping
people resolve health problems associated with a reduction in
MMR, IMR, and Child Mortality Toddler [2].
Posyandu on the Road is a public health service containers
that have the same principles and functioning as regular
Posyandu. However, Posyandu on the Road carried from door
to door that meaning volunteers and health workers visited
one by one of the house that have infants, toddlers, and
pregnant women. Posyandu on the Road have the same
activity with regular Posyandu, but Posyandu on the Road
performed using the car, while the regular Posyandu held in
one of residents house or in the village hall. Posyandu on the
road can be performed in rotation in one village (Posyandu in
the village performed several times), to ease the work of
volunteers and health workers. Posyandu car equipped with
scales infants, toddlers, and pregnant women, as well as other
medical equipment needed in the implementation of the
Posyandu. In addition, Posyandu car is also equipped with
health workers who serve family planning, giving of vitamins,
and health consultations, as well as a nutrition and health
educator who will provide counseling to mothers of infants,
mothers of toddlers, and pregnant women about the
importance of attending to the health and nutrient intake from
foods.
The main activities performed on Posyandu on the Road,
such as services for pregnant women that includes weighing
and height measurement, blood pressure measurement,
monitoring nutritional status (LILA measurement), giving iron
tablets, tetanus toxoid immunization, consultation including
Planning and Prevention of Complications of Childbirth and
postpartum family planning conducted by health workers
assisted by volunteers. Services for infants and toddlers
includes weighing, determination of growth status, education
and consultation by the volunteers, as well as health
screenings, immunizations, and early detection of growth and
development by health workers. Posyandu on the Road also
serve KB (Keluarga Berencana) or family planning with the
giving of condoms, injections of family planning services,
birth control pills by health workers. In addition, the Posyandu
cars also provide nutrition services such as weighing
measurement, early detection of growth disorders, nutrition
consultation, supplementary feeding (PMT), vitamin A and
tablets Fe supplementation. If during the implementation of
the Posyandu was found pregnant women who have Chronic
Energy Deficiency (CED) and toddlers whose weight does not
go up 2 times in a row or below the red line in KMS, the
volunteers can provide guidance to it if the conditions are not
too severe or refer them to the health center if the condition is
severe [1].
Posyandu on the Road is expected to contribute to
improving the quality of human resources will be the potential
for the development of the nation's health. Health
development conditions expected to the public welfare as
indicated by the improvement of indicators of human
development, such as increasing the health of people's
nutritional status, increasing optimal growth and development,
welfare and protection of children, the controlled amount and
rate of population growth, as well as decreasing the gap
between individuals, between communities and between
regions with still more emphasis on preventive, promotive and
empowering families and communities in health. Posyandu on
the Road development can be accomplished with the support
of the government through the health centers to facilitate the
implementation of various health activities in Posyandu.
III. CONCLUSION
Posyandu on the Road is one of the solutions to overcome
the problem of lazy mothers who come to the Posyandu.
Posyandu was carried round from door to door, that meaning
volunteers and health workers visited one by one of the house
that have infants, toddlers, and pregnant women. Posyandu on
the Road have the same activity with regular Posyandu.
Posyandu on the Road is expected to contribute to improving
the quality of human resources will be the potential for the
development of the nation's health.
11
 REFERENCES
[1] [Kemenkes RI] Kementerian Kesehatan Republik Indonesia,
Pedoman Umum Pengelolaan Posyandu, Jakarta: Kementerian
Kesehatan RI, 2011.
[2] N. Sembiring, Posyandu sebagai Sarana Peran Serta Masyarakat
dalam Usaha Peningkatan Kesehatan Masyarakat, Medan: Bagian
Kependudukan dan Biostatistik, Fakultas Kesehatan Masyarakat,
Universitas Sumatera Utara, 2004.

12


 
  
   





  
 
 
 


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19
 The Effect of a Family Psycho-Education Program
on Family Caregivers’Attitude to Care
for Patients with Schizophrenia
I Gusti Ayu Rai Rahayuni 1, Susheewa Wichaikull 2, and Sukjai Charoensuk 3
1
Master of Nursing Science (MNS) Program, Kasetsart University
Bangkok, Thailand
Email: gekaik80@gmail.com
2
Boromarajonani College of Nursing Nopparat Vajira (BCNNV), Bangkok, Thailand
Email: susheewa@yahoo.com
3
Boromarajonani College of Nursing Chakriraj, Ratchaburi, Thailand
Email: sukjai66@yahoo.com

Abstract — The purpose of this quasi-experimental study was to behavioural problems [3]. Families living with family
examine the effect of the family psycho-education program on members who have mental disorders require holistic support
family  caregivers’  attitude  to  care  for  patients  with  in order to decrease the burden and responsibility by sharing
schizophrenia in Bali, Indonesia. The attitude in this study the experience with others [4]. As the impact of the stigma,
included cognitive, affective and behavioural components. The the families try to avoid and protect this condition by adopting
participants were the family caregivers who care for positive behaviours and attitudes [5] As a phenomenon, the
schizophrenia patients. The sample was a group of 37 family negative attitude can affect the families that cannot accept the
caregivers, divided by matching pair-sampling technique into 18
patient who is discharged from a hospital and return to their
participants who received 5 sessions of Family Psycho-Education
(FPE) program as the experimental group and 19 participants family.
who did not receive the intervention as the comparison group. Among Balinese people, attitudes are based on magico-
The activities in the FPE program included building of working religious beliefs and supranatural factors have the influence
alliance, introducing about schizophrenia, caring strategies, and a positive correlation with beliefs, attitudes and
coping mechanism and problem-solving strategies by methods of behaviours about psychiatric disorder, both patients and their
sharing experience, discussion and role play. The Attitudes family caregivers [6] [7]. This opinion was also strengthened
towards Schizophrenia Questionnaire for Relatives was used to by 76 % of patients in two public hospitals in Bali was
assess  the  family  caregivers’  attitude.  Data  analysis used was examined by a traditional healer before being consulted by
paired t-test. The findings show that, the intervention of family
psychiatrists and there are approximately 2,500 traditional
psycho-education program (FPE) had significant effects on
increasing family caregivers' attitudes in terms of cognitive, healers’ practices in Bali [8]. There are many factors related to
affective and behavioural components to care for patients with attitude change, such as ethnic, race, culture, religion, belief
schizophrenia (p < .05). The practitioners need to continue and and health  care  services’  conditions, the group of the family
extend the Family Psycho-Education (FPE) program based on caregivers and relatives [9] [10]. The previous studies
the Balinese culture. Thus, the patients with schizophrenia will suggested that the conditions of attitude change are due to the
be better accepted to live together in their family and community. Balinese belief that mental illness caused by the interaction
between niskala (abstract component) which is usually more
Keywords— Attitude; family psycho-education; schizophrenia commonly treated by a traditional healer and sekala (concrete
I. INTRODUCTION component) that can be treated by a physician [11]. However,
Balinese people believe more in the niskala component as the
Schizophrenia can influence the problems both family and main cause of psychiatric disorders like a supranatural power
patients. Most of patients with schizophrenia (50% - 80%) live or black magic. Although the family has been provided with
or have regular contact with their family members [1] sufficient knowledge and has enough level of education
Approximately, 24 million people worldwide are affected by without supports with a good emotion and feeling (affective),
schizophrenia and more than 50% of them do not receive a good belief (cognitive) and a good behavior intention that
appropriate care [2]. Moreover, in developing countries, 90% can influence their attitude, they will not give appropriate
of schizophrenia patients are untreated. The success of their contribution to support the patient’s recovery. 
care will be affected by role involvement of family at the The family needs a further support to reduce the burden
community level [2]. The annual report of Bali Mental and increase the quality of life of patients with mental illness
Hospital (2012) showed there were 1652 patients diagnosed [12]. It can be achieved through a family intervention. The
with schizophrenia, which is approximately 80.2% from the intervention of psycho-education as a part of individual,
total inpatients. The important factors influencing family family and group intervention can focus on education to help
functions  include  family  psychological  distress  and  patients’  participants managing the challenge and developing coping

24
skills [13]. The specific definition of psycho-education D. Intervention Procedures
include educating about living challenge, developing social The intervention of Family Psycho-Education (FPE)
and resource support, coping skills, supporting emotions, procedure was divided into 5 sessions. Each session of
reducing stigma, exploring feelings, problem-solving skills, training took 90-120 minutes of activities, twice a week. The
crisis-intervention [13]. In the current study, the intervention training was implemented by mixing between Balinese
focuses on attitude change. language and Bahasa Indonesia because the participants were
most comfortable in speaking thus, the researcher could
II. MATERIALS AND METHODS
maintain the quality of the intervention. Each session was
A. Subjects divided into three phases, consisting of the orientation phase
The subjects of this quasi experimental study were 38 family around 20 minutes (greetings, validation and contract of the
caregivers who were concerned and continue to accompany current session), the intervention phase around 60 minutes
patients with schizophrenia to get treatment and medicine at in (key point of the session based on the objective) and the
Primary Health Centre, one of the local areas in Bali, termination phase around 10 minutes (evaluation, follow up
Indonesia. The sample was divided into the experimental and and contract for the next session).
the comparison groups by matching pair sampling technique. The teaching methods used in this intervention comprised
19 family caregivers were selected into the experimental of oral and visual presentations, brainstorming, case studies by
group and were invited to join in 5 sessions of the family learning "real life" situations, practice / role-play discussion
psycho-education (FPE) program. Unfortunately, during the and sharing idea. The multimedia materials consisting of:
intervention, one of the families in the experimental group introductory power point presentation, leaflet or sample
dropped out because of the limitation with physical condition brochure and introductory video were needed to support this
(hospitalization). Therefore, the final samples consisted of 37 intervention.
family caregivers including 18 family caregivers in the
experimental group and 19 family caregivers in the The detailed outline of activities for each session as follows:
comparison group. Data were collected from April to July
2013. Sessions Intervention of Family Psycho-Education (FPE)
Goals Activities
B. Instruments 1 To build a trustful Assessment about family expe-
Joining relationship with riences , strengths and resour-
Data were collected using Attitudes towards Schizophrenia
Session practitioner and ces, goals and expectation with
Questionnaire for Relatives. This instrument was initially other participants schizophrenia patients
developed by Caqueo-Urízar [14].The instrument covers three
attitudes components including affective, cognitive and 2 To provide Education, brainstorming and
behavioural. This questionnaire comprises 9 items rated on a An information about discussion about schizophrenia
Likert scale ranging from strongly disagree (1) to strongly Educa- schizophrenia and patient treatments
agree (5). The instrument was translated into Bahasa tional disease and patient
Indonesia by the technique called back translation. Cronbach's work- treatments
alpha was calculated as an index for the internal consistency shop 1
that provided Cronbach's Alpha 0.936. In order to verify the
3 To provide Education, brain storming, dis-
validity of the subscale, Cronbach's alpha was calculated for
An understanding and cussion and role play and about
each component: behavioural component: α = 0.908, cognitive  Educa- practice about strategies related to caring of
component: α = 0.801, affective component: α = 0.997.  tional strategies related to schizophrenia patient include
The Family Psycho-education (FPE) Program Booklet was work- caring for schizo- strategies of communication and
developed by the researcher. The validity of the booklet was shop 2 phrenic patients creating social support
evaluated by three mental healthcare experts as consultants in
order to check the content validity. The inter-rater reliability 4 To improving 1. Education about coping
of the guideline booklet of FPE was analysed using Cohen's Ongoing family’s coping  mechanism strategies
kappa statistics. As a result, the checklist of implementation FPE 1 mechanism skills 2. Sharing experiences and
discussing current issues
procedure in FPE booklet was almost perfect agreement (k =
3. Coping skills training,
0.842) to be used in the real intervention. practice and role play
C. Ethical Considerations
5 To improving 1. Education about problem
Ethical approval was given by the Ethical Review Board of Ongoing family’s solving strategies
Boromarajonnani College of Nursing Nopparat Vajira FPE 1 problem solving 2. Discussion problem solving
(BCNNV) skill strategies
3. Problem solving training,
practice and role play

25
E. Data analysis procedures TABLE II. COMPARISON OF FAMILY CAREGIVERS’ ATTITUDE
COMPONENTS BETWEEN EXPERIMENTAL GROUP AND
The demographic and socio economic characteristics of both COMPARISON GROUP AFTER INTERVENTION OF FAMILY
groups were compared by using the chi-square test. PSYCHO-EDUCATION (FPE) PROGRAM USING PAIRED T-TEST
Paired t-test was used to test the hypotheses at 0.05 levels of
significance. The data were processed by using SPSS v.17 Compo- Experimental Comparison t p
nents of group (n=18) group (n=19)
III. RESULTS AND DISCUSSION Attitude Mean ( S.D) Mean ( S.D)

F. Results
The first part of the results explains the demographic Cognitive 4.39 (0.979) 6.74 (1.300) -7.079 .000
Affective 4.78 (1.166) 6.26 (1.284) -3.651 .002
characteristics of subjects consisting of age, gender, marital Behavioral 4.56 (0.984) 6.95 (1.026) -7.000 .000
status, education, occupations, the length of living with
patients, the relationships with patients and social acceptance.
All of the demographic characteristics between experimental Table 2 shows that the present intervention has a significant
group and comparison group are homogeneous or equal influence to increase the cognitive, affective and behavioural
(p>.05).The second part of the results explains the Hypotheses components of family caregivers’ attitude to care  for patients
Testing. The first hypothesis is accepted and thus, the result with schizophrenia (p < .05).
can be concluded that there is a significant improvement of
family attitude between pre and post interventions in the G. Discussion
experimental group (p < .05). The second hypothesis also
accepted and thus, the result is presented as follows: The findings of this research show that FPE program was
significant  to  improve  the  family  caregivers’  attitude  for 
TABLE I. COMPARISON OF FAMILY CAREGIVERS’ ATTITUDE caring patients with schizophrenia. The importance of attitude
BETWEEN EXPERIMENTAL GROUP AND COMPARISON GROUP, is the change of perceptions about objects or groups by
PRE AND POST-INTERVENTIONS OF FAMILY PSYCHO-EDUCATION creating situations and efforts to foster attitude change as the
(FPE) PROGRAM USING PAIRED T-TEST (N=37) impact of negative attitude for the schizophrenic patients [15].
The model of Fishbein and Ajzen [16] assumes that the
Attitude Groups n Mean S.D t v -value important basis of attitudes is beliefs but not all beliefs or
score religions may be relevant to our attitudes. Therefore, in order
to change attitudes, we should change these salient primary
beliefs, which occur by altering the expectancies associated
Pre Experimen- 18 20.67 3.343 0.411 .686 with their beliefs or values
Interven- tal group This intervention is accentuated how to stimulate the
tion Compari- 19 20.42 2.987
son group
change of beliefs related to the Elaboration Likelihood Model
(ELM) of persuasion about the processes, which are
Post Experimen- 18 13.72 2.244 -7.862 .000 responsible for attitude change [17]. This model explains that
Interven- tal group the different processes along the elaboration continuum can
tion Compari- 19 20.58 2.694 influence the attitude. Accordingly, high motivation and
son group abilities to reckon are required in order to process high efforts
of influencing attitudes. Some of the variables that influence
attitudes include: the number of information processing
Table 1 show that the attitude of family pre-intervention activities, the perceived personal relevance or the importance
of FPE program between the experimental group and of the communication and message repetition. All of the
comparison group is homogeneous / equal variances (p> .05). variables mentioned are the basis used to encourage, motivate,
However, in the post-intervention, there is a significant and stimulate the participants along the 5 sessions of FPE
difference of the attitude score of family caregivers between intervention in the current study.
the experimental group and the comparison group (p < .05). According to the results the  caregivers’  attitudes have
The result can be concluded that the present intervention has a changed because the main activities in this FPE program may
significant influence to increase family caregivers' attitude to improve all attitude components by sharing experience and
care for patients with schizophrenia. The third part of the discussing information together among the participants who
results explains the analysis components of family caregivers’  have the same problems in every session. Related to this
attitudes toward care for schizophrenic patients. The result is statement, based on the conceptualization of attitudes [18],
presented as follows: individuals are evaluated as favourable or unfavourable of the
new sources of information compared with previous or other
information. Thus, after receiving the information, they have
the opportunity to critically decide about the best ways to
remove a negative belief to be a positive belief and attitude as

26
the stimuli to open their mind. This is also related to the
Calgary Family Intervention Model (CFIM) focusing on
promoting, improving and sustaining effective family
functioning in three domains: cognitive, affective and
behavioural as parts of attitudes. It is believed that the most
profound and sustaining change occurring is family's belief
(cognition) [19].
The advantages of the current intervention are the
experiences that encourage self- introspection. Thus, after
identifying that some families have had the same problems,
they could avoid thinking that is their own problems this
intervention could be considered as guidance to make
decisions together in treating patients.
The unique chance for the participants to socialize, share
experiences and extend social networks is provided in a group
approach to psycho-education [20], [21].
IV. CONCLUSIONS AND RECOMMENDATIONS
The intervention of family psycho-education program
(FPE) has a significant influence to increase family
caregivers’  attitudes  including  affective,  cognitive  and  [8] Suryani, L.K and G.D. Jensen. 1992. Psychiatrist, Traditional Healer and
behavioural to care for patients with schizophrenia in Balinese
culture. The partnership between practitioners with
participants and families needed as an approach in the family
psycho-education. The combination of teaching-learning
process is effective to encourage the participants in order to
critically consider regarding the patients’ recovery and gain all  Families Experiencing Schizophrenia. A Randomized Controlled Trial.
of the benefits from this intervention. The sample was
acquired from 1 of the primary health centre in Bali with a
small number of samples that might be difficult to generalize.
The intervention only focuses on the family caregivers
with schizophrenic patients, which cannot be generally
applicable to other mental disorders. It is a limitation of the
study. Thus, for future studies regarding the family psycho-
education can also involve beliefs, burdens and others related
variables. The similar intervention is also important to be
developed in various countries and cultures. The intervention
needs to be introduced and socialized for practitioners.
In summary, the FPE attitude booklet can be employed as
a guideline to enhance the families’ attitude and consequently  Press, Buckingham
promote quality of life to the patients without being isolated.
Thus, families have important roles and responsibilities to
achieve the goals by increasing positive attitudes toward care
for schizophrenic patients. The program needs to be continued,
considered and extended with the longer times, larger samples
and areas by collaboration between government policy and
other decision makers.
ACKNOWLEDGMENTS
The authors would like to acknowledge STIKES Bali and
DIKTI (Directorate General of Higher Education of Indonesia)
for the financial support to this study. Considerable thanks go
to Bali Mental Health Hospital and Abiansemal 1 Primary
Health Center of Badung regency, Bali province of Indonesia,
which provided the place and participants for the intervention
of the study.
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27
 Factors Associated with Psychological Impact of
Junior High School Students after Earthquake in
Padang, West Sumatera, Indonesia
Milya Novera
Kasetsart University, Bangkok 10900, Thailand
Email: milya_novera87@yahoo.co.id
Abstract— Objectives: To examine factors associated with
psychological impact of junior high school students after
earthquake in Padang, West Sumatera, Indonesia.
Method: This was a cross-sectional study, purposive random
sampling was composed of 270 students were recruited from
three Junior High Schools consist of SLTP 7, SLTP 13 and SLTP
25 in Padang West Sumatera from Mei - June 2013. The
psychological impact were assessed using the Depression Anxiety
and Stress Scales-21 (DASS-21) and Way of Coping
questionnaire was used to measure the coping strategies.
Result: Using the DASS-21 with a score of 22.4% for symptom of
depression, 58.1% and 22.6% was found to suffer anxiety and
stress rescpectively. Factors found to be significantly associated
with depression, anxiety and stress were young age, living
arrangement, loss family member and coping strategies (p<0.05).
Conclusion: Additional research is needed to investigate the long-
term, earthquake-related psychopathology. Nurses should
receive more education about disaster-related psychological
health skills to provide adequate psychological counseling and
intervene successfully to assist students who survived the tragedy
to optimize their psychological health status after earthquake.
Keywords— Psychological Impact; coping strategies; adolescent;
disasters; earthquake
I. INTRODUCTION
Disasters are becoming more frequent, especially in the
Asia-Pacific region. In 2008, 40% of all reported natural
disasters occurred in Asia and more than 80% of the reported
victims lived in that area [1]. Base on previous studies, natural
disaster bring physical and psychological stresses to the
survivors [2]. Indonesia has recently struck by a series of
major earthquakes and subsequent tsunamis that have largely
affected cities. For example, in 2004 tsunami and earthquakes
destroyed Banda Aceh and Meulaboh. In addition, in 2006,
central Java was damaged by earthquake with a following
tsunami [3]. After two years, an earthquake occurred in the
West Sumatera Island, especially in Padang, a magnitude
force of 7.6 on the Richter scale has struck on September 2009.
This earthquake caused significant damage to hundreds of
buildings and the death of 1117 individuals [4]. Padang is the
capital city of West Sumatera Province in Indonesia.
Geographically, Padang has potential hazards of earthquakes,
it is important to note that the city is located on the Eurasian
plate and quite near to the inter-plate boundary between the
Eurasian Plates and Indo-Australian Plates. This inter-plate
boundary is reported to be the most seismically active in the
region [4]. Musa and his colleagues (2012) reported that
people affected by natural disasters like tsunami in Aceh,
earthquake and landslide in West Sumatera were at risk to
develop psychological impact such as depression, anxiety and
stress[5]. The psychological impact often persists for a very
long time after the disaster and represents a further burden to
individuals whose physical and emotional resources have
already been depleted by their own and their beloved ones
losses. In post-disaster studies, researchers have found that
coping is an important predictor of psychological symptoms.
In addition to directly ameliorating or deteriorating
psychological distress, coping has been found to moderate the
relationship between stressors and mental health outcomes in
a few of empirical researches [6].
Adolescence is a developmental period where teens are
particularly vulnerable to traumatic events. This is a
particularly challenging period for this population because
they must simultaneously cope with significant changes in
physical and psychosocial development [7]. Several studies
suggest that teenagers also show depression, belligerence, and
anxiety following a disaster. Incidence caused by the
earthquake that occurred in West Sumatra Island had a
psychological impact on mental health problem in adolescents.
This study concentrated on junior high school students who as
discussed above, are amongst the most vulnerable to
psychological impact. Youth are the future generation of the
nation. The condition of teenagers today can predict future
development of the nation. Therefore, is very important to pay
attention to these teenagers in all aspects of their lives. One of
the most important aspects is mental health. The main
objective of the present study was to examine factors
associated with psychological impact of junior high school
students after earthquake in Padang. Therefore identifying the
risk factors would assist in the future management of
survivors of natural disasters to help them cope up better with
their mental health.
II. MATERIAL AND METTHOD
This cross-sectional study was conducted on Junior high
school students in West Sumatra, Indonesia. A total of 270
respondents were recruited by using purposive random
sampling to choose the Junior high school. Further, to select
the sample in each Junior high school will use simple random
sampling, by inclusion criteria; adolescents in Junior high
schools from first to third grade, students who ages of 11 to 16
28
years old and also have been permitted by the parents or
guardian being participant. Participation of young students
who had experienced by earthquake and also had resided in
Padang at the time of the earthquake and thereafter will
requested for this research, can use effective verbal
communication and willing to participate cooperatively and
for students who have previous mental disorders, Moving out
from Padang city and reject to give consent and
communication barriers will exclude in this study.
Ethical clearance was obtained from the Ethical Research
Committee of Boromarajonani College of Nursing Nopparat
Vajjira and legal study permits were obtained from relevant
authorities in Padang city. The  respondents’  levels  of  stress,  aceh and West Sumatera, was found that young age
depression and anxiety were measured using the Indonesian
version of Depression, Anxiety and Stress Scale 21 (DASS-
21). The DASS has been shown to have high internal
consistency and discriminations in a variety of settings [8].
The Ways of Coping Questionnaire (WOC) is a validated
measure that identifies the thoughts and actions an individual
has used to cope with specific stressful encounters [9]. The
ways of coping consists of 66 items describing a broad range
of behavioural and cognitive coping strategies that an
individual might use in stressful events or medical conditions.
For  content  reliability,  the  cronbach’s  alpha  coefficients  for  This study is contrast with previous findings that the female
ways of coping were α = 0.65-0.88. Data was entered, cleaned
and analyzed using Statistical Package for the Social Sciences
(SSPS Student Version 15.0) for Windows provided by
Kasetsart University.
III. RESULTS
According to Table 1, showed most of the students ages
ranged from 11 to 16 years old andfemale students slightly
over than male. Family income of the participants were in the
lowest socio-economic status, with monthly income below
1,000, 000 rupiah . With regard to living arrangement, it was
found that most of the respondents live with both biological
parents, and more than half 86.7 % of the participant no
relative were loss. In addition, for coping strategies divides
into two patterns consist of Problem focused-coping and
Emotion focused coping. Majority 55.9 % of the participants
had often used problem focused coping and then 50.4 %
emotion focused coping. Table 2 showed 22%–58% of
respondents being either stressed, depressed or anxious.
Table 3 showed that there was statistical association
between age and psychological impact (i.e. depression,
anxiety and stress) with p-value < 0.05. The other variables
such as gender and socio-economic status were not
significantly association with depression, anxiety and stress.
In addition, there was significantly association between living
arrangement and depression, anxiety and stress obtained p-
value < 0.05 (0.016, 0.026, and 0.007 respectively).
Depression and stress were associated with problem-focused
coping strategies and similar with emotion focused coping,
this result only anxiety was not associated with both of the
strategies. Loss family members was also a risk factor for
depression and stress but not to anxiety (p=0.062).
IV. DISCUSSION
The purpose of the study was to examine factors associated
with psychological impact of junior high school students after
earthquake. Among the demographic variables of interest, age
had statistically significant association with depression,
anxiety and stress, the result of this study suggest that victims
of younger age were more vulnerable to depression, anxiety
and stress following a natural disaster. It implies that young
age especially the school-going children, are a vulnerable
group for adverse psychological implication in post-disaster
areas. This result consistent with previous study which also
used same questionnaire for psychological impact in Aceh
significantly associated with depression, anxiety and stress [5].
Actually, the developmental psychopathology in relation to
depression, anxiety and stress has been found to be associated
with age [10]. Similar result with Sopacua (2007) was
reported the younger age who experience with disaster higher
psychological impact than older.
In regard to gender, both genders were well presented in
the study, and consist of mostly equal between male and
female. There was not significant association between gender
and psychological impact i.e. depression, anxiety and stress.
gender is a more predictor of mental issues such as depression,
traumatic stress responses and anxiety than male [12].
Regarding to income, there was a lower income, but
negatively significant associated between socio-economic
status and psychological impact (i.e. depression, anxiety and
stress). This result contrasts with Asgary and Willis (1997)
state that the socio economic status of individuals may also
affect their psychological response to disaster. Lower income
or wealth can place individuals or their households at greater
risk of damage from disasters; because, for example, of poor
housing quality, inferior residential location or inadequate
safety features. Additionally, it was found that the lower the
income amongst the sample, the higher the likelihood of
severe mental illness [14]
In this study, mostly (80.4%) of the participants were live
with both parents. Furthermore, statistical analysis showed
that there was positively significant association between living
arrangement and psychological impact (depression, anxiety
and stress). Perceived support from parents, classmates and
teachers seem to associate with a lower risk of stress. Studies
including natural disasters, community violence, sexual and
psychal abuse, parental homicide and serious illness have
documented  the  importance  of  parental  support  and  parent’s 
capability to cope with the trauma regardless of their own
emotional reaction in preventing post trauma stress disorder
symptoms of children and adolescents [15]. Loss family
members were statistically significant with depression,
anxiety and stress. This result considering that factors related
to the stressor it self may also increase vulnerability, such as
the loss of a loved one, home, or job, or the experience of
injury as a consequence of the event [13,14,15,16,17] This
recent findings is consistent with other research findings was
found that people who lost family members reported
29
significant severe psychological impact compared to those emotions are results of our receiving information. It is obvious
who did not [18]. that a person’s beliefs about stress and their ability can widely
Almost in every way that we want to see coping, we can change the way person responds, that is, his/her behavioural
say that it has two components: a cognitive and a behavioral component of their coping responses. Individuals only use
component. The cognitive component encompasses an emotion focused coping strategies if they were sure that there
interpretative part that  includes  a  person’s  beliefs  system  was chance to manage or alter the stress sources or demands
about identity of stress, his/her ability to expose, and the way from the situation.
he/she should apply. According to Lazarus and Folkman Finally, the limitations of the study need to be
(1984)  define  coping  as  “constantly  changing  cognitive  and  acknowledgement. Firstly, this research was a cross-sectional
behavioural efforts to manage specific internal/external descriptive study that could not convinces the real time of its
demands that appraised as exceeding the resources of the episode so prospective study is recommended. Secondly, it
person. The type of coping strategies were divides by Lazarus could not explain continous sequences of deprression, anxiety
and Folkman (1984) were problem focused coping strategy and stress through all stage of mental health problem.
and emotional focused coping strategy. This study revealed Psychological impact among earthquake survivors along side
that, there were two coping strategies were used in the study experience of other problems could be considered a serious
area, 55.9% of respondent confessed that they often used issue  for  people’s  health status living in such difficult
problem focused coping and about 50.4% of the respondents conditions. Evidence suggests that severe earthquakes even
claimed often used emotional focused coping. In addition, the can cause long standing morbidity [22]. However, past
present study revealed that no significant associations between psychiatric illness also might contribute to this situation [2].
problem-focused coping and anxiety but no significant Unfortunately one of the shortcomings of the present study
associations were found between emotion-focused coping and was did not measure previous psychiatric conditions among
anxiety. Contrast with previous studies, Spurell & McFarlane survivors and thus it was not possible to comment on this
(1993) examined the association between coping strategies further. Thirdly, no information was obtained on important
and the presence of post traumatic stress. The results indicated trauma-exposure variables such as extent of fear or perceived
that the use of more coping strategies was associated with life-threat during the earthquake, rubble experience,
affective disorder or anxiety disorder. dissability or injury, et cetera. Besides, the last point highlight
In this study, problem-focused coping were measured by a potential limitation to this study is did not measure PTSD
planful problem solving, seeking social support and symptom. Thus, since post traumatic stress disorder is also
convrontive coping. Problem focussed coping are used to common in earthquake survivors, this study is limited in not
solve an existing problem by either changing the situation, including a validated diagnostic measure of PTSD.
one’s  behaviour or both [19]. In this study, revealed the TABLE I. SOCIO-DEMOGRAPHIC PROFILE OF THE RESPONDENTS
difference percentage of those who were often used and
those who were rarely used problem focused coping. In this Variables Frequency Percent
study revealed that coping strategies were one of the factor Age (years)
that associated with psychological impact i.e 11-13 107 39.6
depression,anxiety and stress. Furthermore, problem-focused 14-16 163 60.4
coping appears to be associated with reduced depressive Gender
symptoms as this style actively removes or resolves stressors Male 144 53.3
[21]. As stressors are removed before they develop into Female 126 46.7
functionally inhibiting stressors, this may reduce stress levels Socio Economic Status /
and prevent individuals from experiencing more severe Income Family (Rupiah)
psychological distress. Research has also shown that < 2,000,000 124 45.9
≥ 2,000,000 146 54.1
problem-focused coping is adaptive in uncontrollable
Living Arrangement
situations as it provides individuals with a sense of mastery With Parent 217 80.4
and gain [9]. Other Arrangement 53 19.6
Emotion focused coping strategies are employed to Loss Family Member
regulate emotional reactions or to make one feel better No relatives/family were lost 235 87
without actually solving the problem. According to previous Loss relatives/family member 35 13
study emotion focused coping can be adaptive in dealing with Problem-focused coping
in capability feeling in an unclear situation [20]. This Often used 170 63
founding, explained the result from this study that 50.4% were Rarely used 100 37
often used emotional focused coping because the factors that Emotion-focused coping
support respondent to often used this type. Lazarus (1984) Often used 168 62.2
Rarely used 102 37.8
mentioned that distancing, as one of the emotional coping
strategies have been reported to be significantly helpful in
situations that are extremely stressfull, emotially distressing
and appraised as unchangeable. They believe that our

30
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special thank for the participants in this study. Scandinavica, 108, 232-238. 2003.

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46
 Health Psychology of Key to Sustaining and
Thriving of Human Well Being: Self Control,
Conscientiousness, and Adverse Health Behavior
1)2) 3)4) 5)6)
Nur Lailatul Masruroh , Ingga Yonico Martatino , Andri Frediansyah , D. Candra Purnama7), Gusti Jhoni8)
1
Muhammadiyah University of Malang, Indonesia
2
Master of Nursing Science, Graduate School of Kasetsart University, Bangkok 10900, Thailand
Email: faranurlailatul@yahoo.com
3
Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia
4
Department of Psychology, State Islamic University of Sunan Kalijaga Yogyakarta, Indonesia
5
Chulabhorn Graduate Institute, Bangkok, Thailand
6
Indonesian Institute of Sciences (LIPI), Indonesia
7
Forensic Division, State Police Department, Republic of Indonesia
8
Nursing Institute of Muhammadiyah, Pontianak, Borneo, Indonesia
Abstract— this paper explained that a description of several imperative to reduce the prevalence of these behaviors in
adverse health behavior and their health care cost impacts, it society.
was argues that, rather than a focus on external
environmental factors, the intrinsic constructs of self control Adverse Health Behaviors and External Causes
and Conscientiousness should be given more priority in As a great deal of monetary and professional resources
explaining and combating these behaviours. Self control and have been dedicated to combating such widespread risky
Conscientiousness have profound influences on an health behaviors, much of the focus has been on identifying
individual’s choice to succumb to temptation or resist it, external factors (e.g., social, environmental) and exploring
respond impulsively or with self restraint, or seek immediate their relationship to adverse health behaviors [5]. For
versus delayed gratification. Method used literature reviews example, the growing rates of childhood obesity in the
from authoritative databases. Several examples are offered to United States have been blamed on the layout of suburban
illustrate the impact of self control and Conscientiousness on a environments, too much access to fast foods, increasing
mix of common adverse health behaviors and positive health rates of sedentary behavior due to excessive TV watching
behaviors, and through these examples it is argued that self and/or use of computer games [6]. Some have even linked
control and Conscientiousness are unappreciated constructs higher rates of obesity to less educated parents [7,8]. The
in health psychology. Several recommendations for improving focus on external factors such as low education levels and
self control and Conscientiousness are discussed. low socioeconomic status have been implicated in
increased smoking rates, drug use [9,10], risky sexual
behavior [11], and lower levels of health status [12]
Keywords—: self control; conscientiousness; adverse health behavior Self Control
Focus on external factors as causes of adverse health
I. INTRODUCTION behavior may mistakenly confuse symptoms for causes
This scientific paper showed that there are a wide range of [13]. Recognizing that adverse health behaviors begin with
behaviors that have adverse health consequences: smoking and the individual and are keenly linked to individual choice
patterns throughout life but particularly in the developing
increased cancer risk, substance abuse and addiction, risky
years, it is reasonable to look to intrinsic factors as
sexual behavior and increased rates of sexually transmitted contributing causes of an individual’s poor performance in
diseases such as HIV/AIDS, and a range of other factors that school, inability to delay gratification, and inability to
lead to increased rates of overweight and/or obesity [1,2]. Such resist temptations to engage in risky sexual behavior, drug
adverse health behaviors also have significant undesirable use, smoking, overeating, or any other adverse health
impacts on health care costs. Initial estimates indicated that behavior [14].
treatment costs for overweight or obese individuals are $1,723 Self control is a higher order cognitive function linked to
higher for Medicare patients, $1,021 higher for Medicaid the metacognitive ability to consciously step back and see
patients, and $1,140 higher for private insurers [3]. one’s own thought referred to as “Theory of Mind” [15]
Recent research has more than doubled the additional costs Studies in cognitive neuroscience have located
of obesity at $2,800 in additional costs per obese person. The metacognitive self referential abilities in the anterior
cost impact of treating HIV/AIDS is more severe estimated at medial prefrontal cortex, retrosplenial cortex, and caudate
over $20,000 in increased total costs per patient. The nucleus [16]. Self control also seems to have an implicit
combination of private and public costs related to smoking are component that acts to direct individuals away from
estimated at $96 billion annually, with second hand smoke tempting situations in favor of situations which support
increasing health care costs for children by an additional $890 long-term goals [17], and is also a quality with limited
per child per year [4]. Given these costs, it is certainly capacity: self control can wane with extended use, but also

47
be strengthened with proper implicit [18].
Self control is an unappreciated construct in health
psychology: A review of several health psychology textbooks
revealed only one reference to self control [19]. Self
determination was the closest term listed in Robbin [2006, as
in 20] and self regulation theory was the closest to self control
[21]. Even though self control appears unappreciated in health
psychology, there are plenty of examples of how its absence
contributes to the prevalence of adverse health behavior [22].
II. METHOD
A review of the literature is an essential part of research
project . the review is a careful examination of a body of
literature pointing “health psychology” toward the answer this
research question. Literature reviewed typically includes
scholarly journal, scholarly books, authoritative database and
primary sources. Sometimes it includes newspapers,
magazines, other books, films, and audio or video tapes, and
other secondary sources [23].
This paper is guided by a review of the relevant literature. it
be the mechanism by which this research is viewed as a
cumulative process related “health psychology”. That makes it
an integral component of the scientific process
III. DISCUSSION
There is a wide range of research illustrating that a lack of
self control contributes to increased levels of adverse health
behaviors such as smoking, drug use, and alcohol use. In a
study of male high school students of Don bosco Indonesia
found that students who rated low on self control reported
higher rates of smoking, drug abuse, and an inability to
withstand peer pressure. Additionally, students who scored
low on self control also reported incidents of parental abuse.
Similar findings confirming the link between low self control
levels and adverse behavior [24,25] comparing two samples of
students: one from normal high school and one of alternative
high school.
Jongh, Bolt, and Olivier [2007, as in 26] extended the issue
of self control to both behavioral and emotional self control in
the context of smoking, alcohol, and marijuana use among
middle school and high school students. They found that low
behavioral control had a direct impact on student’s affiliations
with other students representing bad influences, and emotional
control had a direct impact on coping. Gropen, Clark,
Hoisington, and Ehrlich [2011, as in 27] explored the
relationship between different levels of self control and
psychological symptoms in relation to engaging in drug abuse,
associating with friends who engage in drug use, and levels of
efficacy supporting nonuse.Through the use of structural
equation modeling (SEM) the authors found that higher levels
of self control had stronger positive relationships with feelings
of well being and less symptomatology while lower levels of
self control showed opposite symptomatology and had adverse
impacts on resistance efficacy. Finally, for further linked low
levels of smoking with high levels of self control [28].
Obesity has definite associations with poor self control.
Kenned, et all [2010, as in 29] explored the relationship
overweight tendencies, overeating, and the ability to inhibit
eating responses. The authors found that failure to inhibit was
a key factor associated with individuals being overweight or
obesity. The flipside of inhibition failure is impulsivity which
has likewise been linked to higher rates of obesity in
children who lack the ability to control the impulse to eat
[30].
Lack of self control has been linked to higher levels of
truancy from school [31] while positive levels of self
control has been identified as the key factor responsible for
success in on line distance learning. Such results clearly
show that self control is a critical factor in success with
education. Given the link between success with education
and higher socioeconomic status, and self reported health
status [32] it is clear that self control is critical factor in all
of them.
Conscientiousness is regarded as one of the Big Five
personality temperaments and is intimately linked to self
control Research has shown that conscientiousness is
represented by many other positive traits including:
“industriousness, order, responsibility, traditionalism, and
virtue” and shown to be negatively associated with many
adverse health behaviours. In addition, conscientiousness
has been positively linked to rational strategies of decision
making, negatively linked to irrational strategies, and also
involved in the coordination of self regulatory traits.
Individuals who possess high degrees of
Conscientiousness are associated with a wide range of
health protecting behaviors. In a study of college students
as in found that students with conscientiousness showed
much higher rates of buckling their seat belts when driving,
engagement in regular exercising, eating a healthy diet,
consuming alcohol at moderate and safe levels, and getting
sufficient rest. A recent meta analysis of the relationship
between Conscientiousness and education also found
Conscientiousness to be as critical as intelligence for
educational success. A large multinational study exploring
the relationship between exercise, personality traits, and
motivation found that Conscientiousness, Openness, and
Agreeableness were associated with motivation to exercise .
Conscientiousness, like self control, has also been
associated with lower rates of smoking and more positive
patterns of coping among hemodialysis patients [33].
IV. CONCLUSIONS AND IMPLICATIONS
This scientific paper has presented of the relationship
between self control, Conscientiousness, and behavior
amply illustrates the importance of both on health. Many
adverse health behaviors such as smoking, drug use,
overeating, and risky sexual behavior are associated with
the absence of sufficient self control and
Conscientiousness while positive levels of both foster more
positive health behaviors such as exercise, and improve the
chances of educational success leading to increased
protection from poverty. There is evidence that self control
and self regulation can be improved with practice and that
the balance of personality tempera-ments can be changed
resulting in less adverse health behavior .
A critical factor in promoting self control is positive
parenting in the first 10 years of a child's life which
suggests there should be a much greater focus on training
and supporting new parents (e.g., teen mothers) in
parenting skills that support the development of child self
discipline potentially up through a child’s pre adolescence.
Developing religiousness also has positive impacts on self
48
control and self regulation. Religiousness appears to direct
individuals to those behaviors and activities which support
self control (e.g., self monitoring, development of regulatory
strength). Given recent trends in increasing church attendance
higher rates of self control nationally may become evident.
In closing, it is argued that self control is an important, yet
unappreciated factor in health psychology. Even though it fails
to be adequately represented in health psychology text books,
self control is an important factor shaping many aspects and
levels of both healthy and adverse health behavior. The same
is true with respect to Conscientiousness. This means both
should be singled out as important health psychology
constructs due to their relationship to many aspects of positive
health, including those core virtues like self control driving
positive health behavior.
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58
 Anticancer Activity of Bruceine A Isolated from
The Seeds of Brucea javanica
on Hela Cell
Dwi Sutiningsih1, Susiana Purwantisari2
1
Faculty of Public Health Diponegoro University, Semarang, Indonesia
Email: dwisuti98@gmail.com
2
Faculty of Mathematics and Natural Sciences Diponegoro University, Semarang, Indonesia
Email: susiana_purwantisari@yahoo.co.id
Abstract— Brucea javanica seeds has been used traditionally
to treat cancer, even though the scientific base of this has not
been completely investigated. Bruceine A from Brucea
javanica exhibit biological activities as a antimalarial,
antitumor, antiviral and antiamoebic activities. This study is to
examine the anticancer activity of Bruceine A from Brucea
javanica seeds include cytotoxic activity and induced p53
protein expression on Hela cell. Cytotoxicity test of Bruceine A
from Brucea javanica seeds has been performed by counting
method of the cell directly with trypan blue exclusion
dye. Analysis of induced p53 protein expression on Hela cell
was detected by using immunocytochemistry technique. Cell
that stained positive p53 protein showed that there was nucleus
or cytoplasm stained with brown color, while the one stained
negative p53 protein would be purple. From cytotoxicity test
results of Bruceine A from Bruceine javanica seeds against
Hela cell, value IC 50 obtained as big as 76.4 µg/ml. From
observation of p53 protein expression on Hela cells by
immunocytochemistry staining, it can be seen that Bruceine A
from Brucea javanica seeds can increase the expression of p53
protein Hela cells by 44.3%. From the result of this study, it
can be concluded that Bruceine A from Brucea javanica seeds
have anticancer activity through inhibition mechanism of Hela
cell proliferation, by activating the tumor suppressor gene such
as p53.
Keywords—Brucein A; Brucea javanica; anticancer; cytotoxic;
p53 protein expression (key words)
I. INTRODUCTION
Brucea javanica belongs to the family of Simaroubaceae
is a shrub which is distributed in Souteast Asia including
Indonesia [1]. The bioactive component of quassinoid from
Brucea javanica has an interesting biological effect [2].
There were javanicosides, flazin, bruceocides, bruceantine,
bruceine, brusatol and terpeniod blumenol A. Some with
glycone or aglycone derivates. The mode of action based on
inhibition of protein synthesis ([2],[3]). These quassinoid
were reported for thheir potential to induce human
promyelocytic leukemia (HL-60) cell differentiationand to
inhibit cyclooxygenase-1 (COX-1), cyclooxygenase-2
(COX-2) and 7,12 dimethyl benz[a]antracence (DMBA)-
induced lessions in a mouse mammary organ culture model.
Bruceantinols and bruceines have been shown to posses as
antibabesial activity with IC50 at 5 ng/mL [4]. Bruceantine
and brusatol have antileukemic effects induced down-
regulate c-myc protein levels [5]. Some quassinoid have
also been found to exhibit antiplasmodial activity againts
Plasmodium falciparum [6]. In this study was conducted to
evaluate cytotoxic activity and induced p53 protein
expression of Bruceine A isolated from the seeds of Brucea
javanica on Hela cell.
II. METHODOLOGY
This study is a purely experimental study with by post-
test only control group design approach.
The seeds of Brucea javanica fruits were purchased and
collected from Merapi Farma Herbal & Co., Yogyakarta,
Indonesia. This sample was identified by Department of
Biology, Faculty of Pharmacy UGM, Yogyakarta.
The cytotoxic activity was tested by assessing their
inhibition of growth of cells derived from human cancer [7].
The cell lines tested was Hela cell. Cells are adapted for
growth in RPMI 1640 media supplemented with 10%
bovine serum and 60 mg/ml amikacin and maintened 150
cm2 flasks at 37ºC and 5% CO2. Into 96 micro plate wells
, contains 100 μl  experimental  cells  with  a  density  of  2 x
10 4 cells / well, added  100μl  of  Bruceine A at various
concentrations levels (1000, 500, 250, 100, 50, 10μg / ml) in 
triplicate. As a control, culture media considered to have
growth of 100% is used. Culture contained the experiment
material was incubated in an incubator with 5% CO 2 stream
at 37 ºC for 24 hours. At the end of incubation, each well
calculated the number of living cells by
using trypan blue. Cytotoxic activity was analyzed by probit
analysis, determined the value of IC 50 concentration
required to inhibit tumor cells up to 50%.
Detection of p53 protein on Hela cell is done using
immunohistochemistry test. Cells stained positive p53
protein showed that there was nucleus or cytoplasm with
brown color.
59
 III. RESULT AND DISCUSSION In this study, an antibody that can detect both wild-
A. Bruceine A cytotoxicity on Hela Cells type p53 protein and mutant in cancer cells is used. So in
In this cytotoxicity test, method of counting cells this study the positive p53 protein expression indicated with
directly using the aid of trypan blue staining was used, brown color in the nucleus or cytoplasm that cannot be
which is based the principle that the dead cell has lost its distinguished between the expression of p53 from wild or
membrane integrity, so that trypan blue can enter the cell. mutant type.
Thus, the dead cell will absorb the blue color, while the Both wild-type p53 protein (wild type) and mutant
living cell does not absorb blue [8] . The average number of migrated in the cell nucleus are known as
living Hela cells after Bruceine A addition at various the Nuclear Localization Signals (NLS) attached to their
concentrations is seen in Table I. From the Table I can be primary sequence [10]. According to [11] and [12], wild-
seen that the higher the concentration, the greater Bruceine type p53 causes growth inhibition in G1 phase, so that
A percentage of Hela  cell’s  death.  In  this  cytotoxicity test, means in order cell to enter S phase, p53 should be
parameter value IC 50 is determined. IC 50 value indicates inactivated..
the toxicity potential of a compound against Hela cell. The
smaller the value of IC 50 means that the compound is more Overall, it can be concluded that quassinoid Brucein A
toxic. Toxicity potential of Bruceine A against Hela cell can cause death to Hela cells. The Hela  cell’s  death 
shown by IC 50 value of 76.4 µg / ml. mechanism is through the mechanism of inhibition of Hela
cell proliferation, as evidenced by an increase in p53 protein
expression in Hela cells. The expression of the p53 protein
B. Analysis of p53 protein Expression on Hela Cells cannot be distinguished whether wild or mutant type p53,
Results of p53 protein detection by but seeing the expression of p53 protein in the cytoplasm
immunocytochemistry, data were obtained on the number of shows that inhibition of Hela cell proliferation through cell
p53 protein expression per 100 cells as presented in Table cycle progression inhibition that occurs in G1 phase. This
II. The Table II shows the dispose of expression increase of provides an opportunity for the genes that control DNA
p53 protein in the treated group compared to the repair to repair the DNA damage that exists.
control. The picture of p53 protein expression in Hela cells
control and treatment with Bruceine A can be seen in Fig.
TABLE I. THE AVERAGE NUMBER OF LIVING HELA CELLS AND
1and 2.
In the Fig.1 and 2 above can be seen that most of the HELA CELL’S DEATH PERCENTAGE AFTER BRUCEINE A ADDITION AT
VARIOUS CONCENTRATIONS
Hela cells control showed positive expression of p53
protein. Thus in Hela cells by adding Bruceine A
concentration  of  10μg/ml  an  increase  in  the  expression  of  Cons. Number of living cells x 10 4
p53 protein positive is seen. This case indicates that the (µg / %
Hela  cell’s  death  through  the  mechanism  of  proliferate  ml) Bruceine A Control Mortality
inhibition, by activating the tumor suppressor gene such as I II III Average I II III Average
p53. Any stress or DNA damage can stimulate the 1000 7.5 7.5 6.0 7.0 45.0 46.5 43.5 45.0 84.4
expression of p53 protein in Hela cells [9]. 500 14.0 15.0 12.0 13.5 43.5 64.5 45.0 51.0 73.5
In Hela cells control or Bruceine A treatment, most of 250 17.0 18.0 15.0 16.5 45.0 48.0 42.0 45.0 63.3
p53 protein expression is located at the cell nucleus, 100 18.0 19.5 19.5 19.0 46.5 37.5 39.0 41.0 53.7
although some located at the cytoplasm (Table III). The 50 29.0 30.0 28.5 29.0 51.0 52.5 55.5 53.0 45.2
existence of positive expression of p53 protein in the 10 38.0 36.0 37.5 37.0 63.0 63.0 52.5 59.5 37.8
cytoplasm shows that inhibition of Hela cell growth occurs
in the G1 phase of the cell cycle. Quassinoid Bruceine A is
estimated can inhibit cell division in the G1 phase of the cell TABLE III. EXPRESSION OF P53 PROTEIN ON HELA CELLS
CONTROL AND TREATMENT BRUCEIN A CONCENTRATION OF 10
cycle by increasing the expression of p53 protein in the µG / ML PER 100 CELLS
cytoplasm. According to [9], p53 gene uses its function
during the G1 phase of the cell cycle. Most of the p53 gene Expression of p53 Protein Hela Cells
acts as: 'the guardian of the genome', i.e. : (1) level of p53 Replication Control Bruceine A
rapidly increased in response to DNA damage, (2) lead to Positive Negative Positive Negative
inhibition of cell cycle during the G1 phase, (3) provide I 29.0 74.0 43.0 62.0
time for cells to repair DNA damage, (4) if the damage II 19.0 83.0 50.0 56.0
cannot be repaired, p53 will induce programmed cell III 17.0 85.0 49.0 60.0
death (apoptosis). Total 65.0 242.0 142.0 178.0
Percentage (%) 21.1 78.8 44.3 55.6

60
TABLE III. LOCATION POSITIVE P53 PROTEIN EXPRESSION IN HELA CELLS IV. CONCLUSION
CONTROL AND BRUCEIN A TREATMENT
In conclusion that Bruceine A from Brucea javanica
seeds have anticancer activity through inhibition mechanism
Locat-
ion of Control Brucein A of Hela cell proliferation, by activating the tumor suppressor
p53 gene such as p53. Anticancer activity test toward Hela cells
posi- Tot Tot showed the IC50 value of Bruceine A was 76.4 µg/ml.
tive I II III al % I II III al %
Bruceine A can stimulate the expression of p53 protein in
Nuc- 23. 12. 35.
leus 0 0 15.0 50.0 92.6 30.0 0 41.0 106.0 89.1
Hela cells by 44.3%.
Cyto-
plasm 1.0 2.0 1.0 4.0 7.4 5.0 4.0 4.0 13.0 10.9 REFERENCES
[1] Syamsulhidayat, S.S., Inventaris Tanaman Obat Indonesia IV,
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Mesecar, A.D., Mehta, R.G., Fong, H.H., Pezzuto, J.M., and
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61
 The in vitro Antioxidant Activity of n-Hexane
Extract of Jatropha curcas L. Leaf
Nurlely 1,4, Srichan Phornchirasilp 1, Rungravi Temsiririrkkul 2, and Yuvadee Wongkrajang3
1
Department of Pharmacology, Faculty of Pharmacy, Mahidol University, Bangkok 10400, Thailand
Email: srichan.pho@mahidol.ac.th
2
Department of Pharmaceutical Botany, Faculty of Pharmacy, Mahidol University, Bangkok 10400, Thailand
3
Department of Physiology, Faculty of Pharmacy, Mahidol University, Bangkok 10400, Thailand
4
Department of Pharmacy, Faculty of Mathematics and Natural Sciences,
Lambung Mangkurat University, South Borneo, Banjarbaru, Indonesia

Abstract— Oxidative stress is one of the well-recognized cause
of many degenerative diseases. The antioxidant activities of many
medicinal plants have been evaluated to obtain the alternative
medicines for the prevention of oxidative damages. Jatropha
curcas L. is a widely used plant. It has been used to treat many
diseases. However, the antioxidant activity of its n-hexane
extract has not been reported. Therefore, this study aimed to
evaluate the in-vitro antioxidant activity of n-hexane extract of J.
curcas L. leaf using DPPH free radical scavenging activity assay,
reducing power activity assay and lipid peroxidation inhibition
assay. The antioxidant activity of the extract was compared with
trolox as reference standard. n-hexane extract of J. curcas L. leaf
was found to be more capable in inhibiting lipid peroxidation
process (IC50=56.629 µg/ml±2.145) than to scavenge DPPH· free
radical (IC50=300.834 µg/ml±4.571). Data from reducing power
activity assay indicated that this extract possessed higher
reductive potential in inducing the Fe3+ ! Fe2+ transformation
compared with control (P<0.05). In conclusion, the n-hexane
extract of J. curcas L. leaf possessed antioxidant activity.
Keywords—Jatropha curcas; antioxidant activity; n-hexane extract.
I. INTRODUCTION
Cells in our body use oxygen to generate energy
and free radicals are produced as a consequence of
this process. Reactive oxygen species (ROS) and
reactive nitrogen species (RNS) are 2 products
generated by the cellular redox process. They can
be toxic in our body at high concentration, resulting
in oxidative stress which might trigger many
degenerative diseases such as cancer, arthritis,
autoimmune disorders and cardiovascular ([1]). The
continuous formation of free radicals in our body is
normally controlled by endogenous antioxidants
through inhibition or delay the oxidation of lipids
or other molecules. This action inhibits the
initiation or propagation of oxidative chain reaction
through one or more of these mechanisms including
reducing activity, free radical-scavenging, potential
complexing of pro-oxidant metals and quenching of
singlet oxygen ([2], [3]).
Jatropha curcas L. or Thai local name,
“saboodum”, is a multipurpose drought resistant
plant in the Euphorbiaceae family. Having high
economic utility, it is widely grown in Thailand and
other countries. The seed of J. curcas contains high
quality oil which can be primarily used as biodiesel.
Other parts of this plant especially leaf, however,
have been proven to be capable in treatment of
many diseases. The leaf of J. curcas possesses
many chemical compounds. Flavonoid, apigenin,
vitexin, isovitexin, sterols and triterpenes have been
identified ([4]). The specific compound, a complex
of 5-hydroxypyrrolidin-2-one and pyrimidine-2,4-
dione has also been isolated from the leaf. This
compound has not been discovered in other
Euphorbiaceae plants ([5]). Flavonoids, saponin and
plant sterols are also effective compounds to
produce antioxidant activity ([6]-[8]). However, the
antioxidant activity of n-hexane extract of J. curcas
L. leaf has not been examined. Therefore, this study
was conducted to assess the antioxidant capacity of
n-hexane extract of J. curcas L. leaf as compare to
the antioxidant reference standard.
II. MATERIALS AND METHODS
A. Reference Standard and Chemicals
Trolox, ascorbic acid, 2,2-diphenyl-1-
picrilhydrazyl (DPPH), bovine brain phospholipids
extract type VII, thiobarbituric acid (TBA), 2,6-di-
tert-butyl-p-cresol were purchased from Sigma
(Sigma-Aldrich, GmbH). Polyoxyethylenesorbitan
monolaurate (tween 20) were obtained from S.Tong
Chemical Co.Ltd, Thailand. All other chemicals
used were analytical grade and purchased from
either Merck or Carlo Erba.

62
B. Plant Material
J. curcas L. fresh leaves were collected from DPPH scavenging capacity (%) = (Ab-As)/Ab x
Kasetsart University, Kamphaeng Saen campus, 100
Nakhon Pathom Province, Thailand. The plant was
taxonomically authenticated by Assoc. Prof. Where, Ab = absorbance of the blank
Rungravi Temsiririrkkul. A representative voucher As = absorbance of sample
specimen was deposited at Department of The percentage of DPPH scavenging activity
Pharmaceutical Botany, Faculty of Pharmacy, versus concentration of sample was plotted and
Mahidol University. calculated to obtain the IC50 value (concentration of
sample which exerted a 50% of DPPH scavenging
C. Preparation of Plant Extract
activity) using Graphpad Prism version 5.0. The
The n-hexane extract of J. curcas leaf was kindly percentage of DPPH scavenging activity was
provided by Assoc. Prof. Rungravi Temsiririrkkul. expressed as mean IC value ± SEM.
50
Fresh leaves of J. curcas L. were washed, dried in a
hot air oven and pulverized. The dried powder of E. Reducing Power Activity Assay
leaves (1.5 kg) was percolated with n-hexane A slight modification of the method described by
solvent. The hexane was then removed from the Oktay et al and Chayarop et al ([10, [11]) were
filtrate using a rotary vacuum evaporator. The applied to determine the reducing power activity of
concentrated extract was finally evaporated in the n-hexane extract of J.curcas L. leaf. A stock
fume hood to obtain the crude extract (37.97 g). solution of extract was prepared by weighing 140
mg of crude extract and dissolving with 10% v/v
D. Free Radical Scavenging Activity Assay
tween 20 in methanol up to volume of 10 ml
The DPPH free radical scavenging method was quantitatively. The stock solution was then filtered
used to evaluate the antioxidant capacity as using a filter with pore diameter of 0.45 µm. 0.5 ml
described by Brand-Williams et al ([9]) with slight of each working solution was mixed with 0.5 ml of
modification. The 0.2 mM DPPH solution was 0.2 M sodium phosphate buffer (pH 6.6,) and 0.5
prepared by weighing 7.9 mg of DPPH and ml of 1% potassium ferricyanide. After shaken well,
dissolving it with methanol up to volume 100 ml the mixture was incubated at 50°C for 20 minutes.
quantitatively. Stock solutions (3 mg/ml) were The reaction was stopped by adding 2.5 ml of 10%
prepared by dissolving 75 mg of crude extract in 25 TCA. Then, it was centrifuged at 650 rpm for 10
ml of 10% v/v tween 20 in methanol. The stock minutes. 0.5 ml of the supernatant obtained was
solution was filtered with 0.45µm filter syringe mixed with 0.4 ml of deionized water and 0.1 ml of
before diluting with methanol to obtain the working 1% FeCl . The final concentration obtained was 50-
3
solutions of different concentrations (300-1800 1000 µg/ml. Trolox (50-1000 µg/ml) was used as a
µg/ml). One ml of each working solutions was reference standard. Corresponding blank was
mixed with freshly prepared 0.2 mM DPPH prepared using vehicle in the absence of extract or
solution (2 ml) to obtain the final concentrations of standard. The absorbance was measured
100-600 µg/ml, then incubated in the dark room at spectrophotometrically at 700 nm. Increased
room temperature for 30 minutes. After incubation, absorbance represents an increase in reducing
the absorbance of each solution was measured at power. Triplicate samples were used for each assay.
516 nm using UV-VIS spectrophotometer The results were expressed as mean values ± SEM.
(Shimadzu L-2600). Different concentrations (1-10 The absorbance of each sample at 700 nm was
µg/ml) of trolox was used as reference standard. plotted against each concentration of samples.
Corresponding blank was prepared by adding
vehicle to 2 ml of 0.2 mM DPPH solution. F. Non-enzymatic Lipid Peroxidation Inhibition Assay
Triplicate samples were used in this assay. The extent of inhibition on lipid peroxidation was
The DPPH scavenging capacity of each sample determined using TBARS assay as described by
was expressed as percentage of inhibition Burits and Bucar ([12]) and Siriwatametanon et al
calculated by the following equation : ([13]) . Liposomes were prepared from bovine brain

63
extract type VII by mixing with 5 mg/ml PBS pH
7.4 and homogenizing under cold temperature until
obtaining a milky solution. The reaction solution in
a total volume of 100 µl contained 50 µl bovine
brain extract suspension, 30 µl extract compound
dissolved in PBS/tween 20, 10 µl 1 mM FeCl3 and
10 µl 1 mM ascorbic acid. All reagents were freshly
prepared. This solution was shaken well. After
incubation at 37°C for 1 hour, TBA (1% in 50 mM
NaOH, 100 µl), TCA (2.8%, 100 µl) and 2,6-di-
tert-butyl-p-cresol (2%, 10 µl) were added into the
sample solution and incubated at 80°C for 20 min.
After cooling down for 10 min, 250 µl of 99% n-
butanol was added and shaken well. The solution
was then centrifuged at 3500 rpm for 5 min. The
absorbance of supernatant (100 µl) was measured at
534 nm. A blank was prepared without adding Fe-
ascorbate while a control was obtained by only
adding vehicle. Trolox was used as a reference
standard. The percentage of inhibition (I) of lipid
peroxidation was calculated according to the
following equation:
I (%)=(Ac-As)/Ac x 100
Where Ac was the absorbance of the control
while As was the absorbance of the sample
containing the inhibitor.
G. Statistical Analysis
The data were analyzed statistically using
Student’s unpaired t-test to determine the different
between two groups whereas multiple comparisons
were analyzed by one-way analysis of variance
(ANOVA) followed by a least significant difference
(LSD) test. Data were analyzed by SPSS (version
17.0 for windows). The IC50 values were calculated
using Graphpad Prism version.5 software for
windows. All data are expressed as mean ± SEM.
III. RESULTS AND DISCUSSION
A. Free Radical Scavenging Activity Assay
In this study, the stable nitrogen free radical,
DPPH•, was used to test the radical scavenging
activity of n-hexane extract of J. curcas L. leaf.
This method is widely used and considered as one
of the standard and easy colorimetric assays to
evaluate the antioxidant activity of pure compounds
([14]). Another advantage of DPPH• scavenging
activity assay is that it is unaffected by certain side
reactions, such as metal-ion chelation and enzyme
inhibition. The principle of this method was based
on the antioxidant molecules of compounds in the
plant which can donate a hydrogen (H) atom to
DPPH• radical of DPPH solution, resulting a non-
radical form of DPPH2 molecule. This reaction
faded purple colour of DPPH solution or changed it
to yellow in the presence of antioxidant ([10]). The
amount of reduced DPPH• was monitored
spectrophotometrically at 516 nm. Figure 1
illustrated the scavenging activity of trolox and
extract. Both trolox and extract reduced DPPH•
stable free radical in a dose dependent manner. The
values of IC50 of trolox and extract were 5.0937
µg/ml ± 0.046 and 300.834 µg/ml ± 4.571
respectively. The extract exhibited less potent
scavenging activity than trolox. It might be
explained that the amount of hydrogen donor
molecules in this non-polar extraction of J. curcas
L.leaf was low.
Scavenging)activity)of)trolox)and)extract
100 Trolox
90
(10, 96.884) Extract
80
(7.5, 76.564)
(600, 84.118)
Scavenging activity (%)
70
(450, 67.915)
60
50
(5, 49.568) (300, 50.274)
40
30
20 (150, 24.236)
10
(2, 20.837)
(100, 19.396)
0
(1, 11.374)
0 50 100 150 200 250 300 350 400 450 500 550 600
Concentration (µg/ml)
Fig. 1. Free radical scavenging activity of trolox as reference standard (n=3)
and extract (n=3) at different concentrations. Each value is expressed as
mean ± SEM.
B. Reducing Power Activity Assay
The activity of ferric ion (Fe3+) reduction was
determined according to this assay. Different from
DPPH• radical scavenging activity, this assay was
carried out to assess electron-donating activity of an
antioxidant compound as a reductant. This activity
leads the reduction of the Fe3+ from ferrycyanide
complex to the ferrous (Fe2+) form. Moreover, the
64
yellow colour of ferricyanide complex changed to
various colour of green and blue depending upon
the reductive ability of each antioxidant compound
in the sample. Therefore, the ferrous form was
measured spectrophotometrically by the formation
of Perl’s Prussian blue at 700 nm ([10], [15], [16])
The reducing power activity of n-hexane extract
of J. curcas L. leaf and trolox are illustrated in
Fig.2. All concentrations of either extract or trolox
revealed higher reducing power activities than
control and these differences were statistically
significant (P<0.05). It indicated that both samples
had an antioxidant activity which may be related to
its electron donating ability. The extract as well as
trolox showed a dose-dependent reducing power at
concentrations ranging from 50-1000 µg/ml.
Nevertheless, the antioxidant activity of extract was
lower than trolox and its activity was significantly
difference (P<0.05). This less potency may be
attributed to a small amount of phenolic compound
in the extract ([17]) since phenolic antioxidant
activity has an important role in electron-donating
activity of this assay ([18]).
aldehydes that reacted with TBA after heating for
20 min and resulted a solution with pink colour
([20]). The amount of MDA and other aldehydes
produced was measured spectrophotometrically at
534 nm.
Both trolox and the plant extract inhibited Ferric
ion-ascorbate-induced peroxidation of liposomes in
a dose-dependent activity but trolox was more
potent than extract as shown in Fig. 3. The IC50
values of trolox and extract were 5.935 µg/ml ±
1.176 and 56.629 µg/ml ± 2.145 respectively.
Therefore it was shown that the antioxidant activity
of extract was higher in lipid peroxidation assay
than DPPH• radical scavenging assay.It might be
related to the non-polar compounds, phytosterols,
extracted in percolation process such as β-sitosterol.
Regarding to the previous report, the n-hexane
extract of J. curcas leaf contained β-sitosterol as a
main compound ([17]). Therefore, this extract
should possess high capability to scavenge OH•
radical in lipid peroxidation process ([19]).
Lipid%peroxidation%inhibition%of%trolox%and%extract

80 Trolox
Extract
70
(450, 67.764)
(8.93, 65.450) (223, 68.225)
60
(89.3, 58.201)
(6.69, 54.555)
% of inhibition

50
(44.6, 45.480)
40 (2.23, 41.475)

30 (0.35, 32.899)

(22.3, 25.372)
20

10

0 50 100 150 200 250 300 350 400 450 500

Concentration (µg/ml)

Fig. 2. Total reductive potential of different concentrations of trolox and n-

hexane extract of J.curcas leaf. Compared with the control using Fig. 3. The percentage of inhibition of the non-enzymatic lipid peroxidation
spectrophotometric detection of the Fe3+ - Fe2+ transformations. *P < 0.05 by trolox (n=3) and extract (n=2). Each value is expressed as mean ± SEM.
compared with the control. #P < 0.05 compared with the same concentration
of trolox. Each value is expressed as mean ± SEM (n=3)

C. Non-enzymatic Lipid Peroxidation Inhibition Assay IV. CONCLUSION

This assay was conducted to assess hydroxyl
radical (OH•) scavenging activity of the antioxidant
compounds in a sample. The OH• was induced by
adding ferric ion of FeCl3 in the presence of
ascorbic acid as a reducing agent. Bovine brain
extract was used as liposomes in a lipid
peroxidation model system ([19]). This reaction
produced malondialdehyde (MDA) and other
The n-hexane extract of J. curcas L. leaf was
evaluated for its antioxidant activity by three
methods based on hydrogen donating ability,
electron transfer capacity and hydroxyl radical
scavenging activity. In lipid peroxidation assay, the
extract expressed a stronger antioxidant activity,
compared with the other two methods. The non-
polar compound in this extract especially

65
phytosterols such as β-sitosterol was proposed to be
responsible for this potent inhibition on lipid
peroxidation. However, the β-sitosterol content in
this extract and the antioxidant activity of n-hexane
extract of J. curcas L. leaf in parallel to its
inhibition of lipid peroxidation should be
established prior to conclude that β-sitosterol plays
an important role in lipid peroxidation inhibition
induced by n-hexane extract of J. curcas L. leaf.
ACKNOWLEDGMENT
The expense of this research was from
scholarship of Directorate General of Higher
Education, Ministry of Education and Culture, the
Republic of Indonesia managed by the Faculty of
Graduate Studies, Mahidol University, Thailand.
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98
Anti-Fatigue Activity of Honey From Apis mellifera,
Apis cerana, and Trigona sp in Mice
Mukti Priastomo1, I Ketut Adnyana1, Sukrasno2
1
Pharmacologhy Research Group, School of Pharmacy, Institut Teknologi Bandung (ITB),
Email : omgigit@gmail.com
2
Pharmaceutical Biology Research Group, School of Pharmacy, Institut Teknologi Bandung (ITB)
Email : sukras@fa.itb.ac.id

Abstract---Fatigue is a major factor in the decline in the
quality and quantity of the athlete's performance. The
cause of fatigue is the accumulation of lactic acid in the
muscles. This is caused by the body's ability to neutralize
lactic acid is not proportional to the speed of lactic acid
formed by the severity of sports activities undertaken, if it
lasts long, it will interfere with the performance. In the
present study, we investigated the anti-fatigue activity in
male mice of honey from Apis mellifera (HAM), Apis
cerana (HAC), and Trigona sp (HT) using a forced
swimming test. Mice were divided into four groups (three
honey administered groups and the control group). The
control group were gave with distilled water and honey
administered groups were gave with honey (1,14 g/ body
weight). After three weeks, a forced swimming test was
performed and the biochemical parameters related to
fatigue were examined. The results suggested that honey
could extend the swimming time to exhaustion of the mice,
as well as increase the tissue glycogen contents, while
decreasing the blood lactate and maintaning blood glucose
level. This indicated that honey had anti-fatigue activity
and could elevate the exercise tolerance.
Keywords--anti-fatigue; Honey; forced swimming test; lactic
acid, glycogen
I. INTRODUCTION
About 20.000 honey bee species can be found
throughout the world, except in Antarctica. In Indonesia
the most developed honey bees are Apis mellifera, Apis
cerana and Trigona sp.
Honey is full of nutrients and healing agents. It was
sweet, the consistency is thick, opaque liquid, pale
yellow brown or yellowish stored in the honeycomb.
Honey has long been believed to increase stamina or
energy. Constituent of honey is a mixture of dextrose
and fructose with the same amount and are known as 50-
90% invert sugar from sugar and water that is not
inverted. A daily dose of 20 gram honey will cover
about 3% of the required daily energy [1].
Fatigue is a complex phenomenon that can be
described as a time-dependent exercise-induced
reduction in the maximal force generating capacity of a
muscle [2]. Fatigue is divided into physical and mental
fatigue. It is known to be accompanied by a feeling of
extreme physical or mental tiredness, resulting from
severe stress and hard physical or mental work. It can be
divided into two categories: physical fatigue caused by
such things as forced exercise or swimming; mental
fatigue caused by sleep deprivation, etc [3].
Concentration of lactic acid in the blood is the best
indicator to see the post-exercise maximum effort [4].
Therefore, the present study is to investigate anti-fatigue
activity of Honey From Apis mellifera, Apis cerana, and
Trigona sp with WFST method in male mice.
II. EXPERIMENTAL
A. Chemicals
All chemicals were purchased from Bandung Institute of
Technology, Indonesia unless otherwise indicated.
Commercial diagnostic kits used to determine blood
lactate, blood glucose level, and tissue glycogen.
B. Material
The honey was obtained from three species of Apis
mellifera, Apis cerana and Trigona sp. The honey was
taken from Malang City, East Java, Indonesia. Honey
bees has been confirmed in the School of Biological
Technology (SITH), Institut Teknologi Bandung (ITB),
Indonesia. Test characteristics of honey has been
conducted in accordance with the Indonesian National
Standard (SNI).

99
C. Selection of animal and care
Twenty male albino mice weighing between 20 - 30 g
were housed under standard laboratory conditions and
maintained on natural light and dark cycle and had free
access to food and water. Animals were acclimatized to
laboratory conditions before the experiment. Each
animal was used only once. The protocol was approved
by local animal study committee. It is under controlled
conditions of temperature 23±1◦C, humidity about 40-
60%, and they were given free access to water and a
commercial diet. The care and treatment of experimental
animals conformed to the guidelines for the ethical
treatment of laboratory animals. The mice were
randomly divided into four groups (n = 5 in each group).
The control group were administered 1 mL distilled
water every day for three weeks. All samples of honey
from the Apis mellifera, Apis cerana and Trigona sp
were given at a dose of 1.14 g/kg body weight for 3
weeks.
D. Forced swimming test
The test was used Weight-loaded Forced Swimming
Test (WFST) as described previously with some
modifications. One hour often the last oral
administration [5], five mice were taken out from each
group for swimming exercise supporting constant loads
attached to the tail corresponding to 10% of their body
weight. The swimming exercise was carried out in a
glass pool (50 cm x 50 cm x 30 cm) 20 cm deep with
water maintained at 27 ± 2 °C. Exhaustion was
determined by observing loss of coordinated movements
and failure to return to the surface within 10 s, and the
swimming time was immediately recorded [6].
E. Measurement blood glucose level
Measurement of blood glucose levels before and after
weight-forced swimming test (WFST). Measurements
using a Glucose Analyzer Test (Easy Touch®) by using
the blood test obtained from a vein of mice tail.
F. Measurement blood lactic acid content
After a period of three weeks, five mice were taken out
from each group for blood lactate analyses. The blood
samples were collected from the veins of the tails of
mice 30 mins after administration and 30 mins after
weight loading swimming (2% body weight),
respectively [2]. Then blood lactate contents were tested
according to the recommended procedures provided by
the commercial diagnostic lactate reagent set from
Pointe Scientific®.
G. Measurement of tissue glycogen contents
Glycogen is the storage form of glucose in the network.
Synthesis and degradation of glycogen to glucose
regulated well enough energy available to the body's
needs [7]. One hour after the weight forced swimming
test, the mice were sacrificed. Immediately liver and
gastrocnemius muscle were quickly dissected out liver
and gastrocnemius muscle were dried with a temperature
of 50 Celsius for 24 hours. When obtained organs and
muscle tissue dried, then ground to a powder. Then the
powder weighed 25 mg of sample, and extracted with 1
mL of 30% KOH and incubated in a water bath for 20
minutes. Afterwards settling at room temperature until
cool, then added with 1.5 mL of ethanol (95%) and
stored at 4 C for 30 minutes. Then centrifuged at 2,500
rpm for 20 minutes. The precipitate obtained was diluted
with 1 mL of distilled water. 100 µL samples were taken
and added to 3 mL of 0.2% anthrone reagent (Sigma
Elrich®), and then measured with a spectrophotometer at
620 nm wavelength.
III. RESULTS AND DISCUSSION
A. Effect of honey from Apis mellifera, Apis cerana,
and Trigona sp on the body weight of mice
The body weights of the mice were measured after they
were administrated with honey from three species of
honey bees for three weeks. As shown in Figure 1, the
increased weights in the experimental groups were of no
significant difference compared with the fourth (control)
group (P > 0.05), so honey had no significant effect on
the body weight of mice.
B. Effect of honey from Apis mellifera, Apis cerana,
and Trigona sp on swimming time to exhaustion of
mice
The result of the effect of three kinds of honey on
swimming-to-exhaustion time are shown in Fig 2. It is
shown an increase in swimming time in each group.
However, it appears that there was a significant increase
in swimming of three different types of honey samples
compared with the fourth group (control) (P> 0.05). The
weight loaded forced-swimming test is commonly used
for behavioral despair, has been used extensively for the
evaluation of the anti-fatigue properties of novel
compounds [8]. In the present study, the data showed
that administration of three kind honey could evidently
extend swimming time to exhaustion of mice, which
indicated that honey had anti-fatigue activity and could
elevate the exercise tolerance. The best evidently extend
swimming time had shown in first group (Honey of Apis
mellifera or HAM).
C. Effect of honey from Apis mellifera, Apis cerana,
and Trigona sp on glucose level of mice
Glucose is the most important carbohydrate. Glucose is
the main fuel for mammalian tissues. This element is
converted into another type of carbohydrate that has a
100
very specific function, such as glycogen for energy
savings; ribose in nucleic acids; galactose in milk
lactose [9]. However, knowing glucose levels can
predict the energy used. In figure 3, we can see the
percentage reduction in blood glucose levels in all
groups. Comparing the percentage of decrease in blood
glucose levels before and after the sample giving the
sample. Results showed the group one (HAM) and
group three (HT) after administration of the sample, can
keep blood glucose concentrations compared with the
control group (C). However, Maintenance of blood
sugar levels not seen in the second group (HAC).
35
30
Body weight (g)
Blood lactic acid concentration is one of the most often
measured parameters during clinical exercise [10]. It is
one of fatigue-relevant factors measured before and after
exercise [11]. Rapid breakdown of glycogen and glucose
in muscle during intense exercise causes a large increase
in lactic acid production [12]. If anaerobic glycolysis
continues, the accumulation of lactic acid during
anaerobic exercise is expected to contribute to the aches
and pains experienced while following heavy exercise
[13]. As shown in Figure 4, that the sample group
MAM, HAC, and HT shows the percentage decrease in
lactic acid formation as much as 41.18% (HAM),
76.82% (HAC), and 29.23%. However, increasing levels
of lactic acid by 8.11% in the control.
These results indicated that the PCP treated mice
experienced a reduction in lactic acid production and/or
an increased rate of lactic acid removal, which may be

25 another pathway of PCP alleviating exercise-induced

fatigue.
20
15 Initial
40
10 Final 35
5 30
Percentage

0 25
HAM HAC HT C 20
Initial
Group 15
10 Final
5
Fig. 1. Effect of Honey on the body weight of mice. Values are means
± SD. * P < 0.05 when compared to the control group (fourth group) 0
(n = 5 per group). HAM HAC HT C
Grups

2500
Fig. 3. Percentage of decrease in blood sugar levels before and after
gave sample
Swimming time (S)

2000

1500 E. Effect of honey from Apis mellifera, Apis cerana,

HAM
and Trigona sp on tissue glicogen of mice
1000 HAC
Glycogen stored in the liver and muscles as an energy
HT reserve and balancing glucose concentration.
500
C Glycogenesis activated in skeletal muscle by a rise in
insulin concentrations after consumption of
0
carbohydrates. In the liver, glycogenesis directly
1 2 3 4 activated by an increase in circulating glucose, fructose,
Week galactose, or insulin concentrations. Prolonged exercise
is associated with depressed rates of skeletal muscle
sarcoplasmic reticulum (SR) Ca2+ transport as well as a
Fig. 2. Effect of Honey on swimming time to exhaustion of mice. decline in muscle glycogen [14]. As shown in figure 5,
Values represent the means ± SD (n = 5 per group). *P < 0.05 when
compared to control group after swimming test, liver glycogen contents all group
sample (HAM, HAC, anda HT) were significantly
higher than control group (P < 0.05). But, in muscle
D. Effect of honey from Apis mellifera, Apis cerana, glycogen levels in all samples does not look
and Trigona sp on lactic acid level of mice significantly different. Thus, the glycogen contents are

101
sensitive parameters related to fatigue. In the present
study, the data showed that honey might increase tissue
glycogen contents of mice post exercise by improving
glycogen reserve, or by reducing the glycogen
consumption during exercise, or both. However, the
detailed mechanism of this phenomenon is not lear and
needs further study.
120
100
Percentage
ACKNOWLEDGMENT
Scholarship from Lembaga Penyalur Dana Pendidikan
(LPDP) Ministry of Finance of the Republic of
Indonesia
REFERENCES
[1] Bogdanov, Stefan., Tomislav Jurendic., Robert Sieber., and
Peter Gallman. (2008). Honey For Nutrition and Health.
American Journal of The Collage of Nutrition. P 677-689

80 [2] Zhang, Xue-Ling., Feng Ren., Wei Huang., Ren-Tao Ding.,

60 Qiu-Sheng Zhou and Xin-Wei Liu. (2011). Anti-Fatigue
Initial Activity of Extracts of Stem Bark From Acanthopanax
40 senticosus. J Molecules 16, 28-37
Final [3] Jin, Hong Mei amd Ping Wei. (2011). Anti-Fatigue Properties
20
of Tartary Bucweat Extracts in Mice. Int. J. Mol. Sci, 122,
0 4770-4780
HAM HAC HT C [4] Smith, Joseph H. (2005). Validity and Reability of the Hawai
Groups Anaerobic Test
[5] Zhang, Gang., Si-Min Zhou., Jun-Huai Tion., Qing Yuan Huang
and Yu-Qi Guo. (2012). Anti Fatigue Effects of Methazolamide
in High-Altitude Hypoxic Mice. Tropical Journal of
Fig. 4. Percentage of decrease in blood lactic acid content before and
Pharmaceutical Research 11 (2) : 209-215
after gave sample
[6] Xin, Xu Yong and Zhang Jian-Jun. (2013). Evaluation of
Antifatigue Activity of Total Saponins of Radix notoginseng.
16 Indian J.med Res 137. pp. 151-155
14 [7] Kolman, Jan and Klaus Heinrich Roehm. (2005). Color Atlas of
Biochemistry 2nd Edition
12
glycogen (mg/g)

[8] Lim, Ming Yeong. (2007). Metabolism and Nutrition 3rd

10 Edition. p 12-13
[9] M. N. Saraf., Sanaye M. M., and Mengi S.A. (2011).
8
Liver Antifatigue Effect of Murraya koenighi. Pharmacologyonline 2
6 : 1025-1037
4 Muscle [10] Goodwin, Matthew L., James E Harris., Andres Hernandez., and
Bruce Gladden. (2007). Blood Lactate Measurements and
2 Analysis During Exercise : A Guide For Clinicians. Journal of
0 Diabetes Sciences and Technology. p 558-569
HAM HAC HT C [11] Jinchao, Wang and Wang Kangkang. (2012). Fatigue-alleviating
Effect of Polysaccharides From Cyclocarya paliarus (Batal)
Grups Iljinskaja in Mice. African Journal of Microbiology Research
vol. 6 (24) pp. 5243-5248
[12] Hargreaves, Mark. (2005). Sport Science Exchange 98 Volume
Fig. 5. Effect of honey on tissue glycogen of mice. 18 Number 3. Metabolic Factors in Fatigue
[13] Murray, K. Robert., David A. Bender., Kathleen M. Bothman.,
Peter J. Kennely., Victor W. Rodwell., and P Anthony Weil.
IV. CONCLUSION Harper’s Illustrade Biochemistry 28th p. 113
[14] Bats, Timothy W., Simon J. Lees., Jay H. Williams. (2009).
Combines Effects of Exercise and Fasting on Skeletal Muscle
In conclusion, the data suggested that three different
Glycogen and Sarcoplasmic Reticulum Function. Basic Applied
honeys from Apis mellifera, Apis cerana, and Trigona sp
Myology 19 (5 & 6) : 247-252
could extend the swimming time to exhaustion of the
mice, as well as increase the tissue glycogen contents,
and decrease the blood lactate and can maintain blood
glucose level. These results indicated that three different
honeys had anti-fatigue activity and could elevate
exercise tolerance. However, further studies are
necessary to clarify the detailed mechanism involved in
the anti-fatigue properties of three different honeys.

102



  






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