International Journal of Social Health

Research Ethics of Natural Medicinal Plants in The Perspective of CIOMS-WHO 2016

2026-09-10T06:09:37+00:00

Research into natural medicinal products (NAPs) from medicinal plants is growing rapidly in line with the increasing use of traditional and complementary medicine in various countries, including Indonesia. However, NAP research poses complex ethical challenges, involving safety, scientific validity, protection of traditional knowledge, involvement of indigenous communities, and equitable benefit sharing. This article aims to analyze the relevance and implementation of the 2016 CIOMS-WHO Ethical Guidelines in medicinal plant OBA research in Indonesia through a literature review approach. The discussion focuses on the main principles of the 2016 CIOMS, including social value and scientific validity, informed consent, risk-benefit assessment, protection of vulnerable populations, community engagement, and access and benefit sharing in the utilization of genetic resources and traditional knowledge. This article was compiled using a narrative literature review approach of various international publications and regulations related to the ethics of medicinal plant OBA research. It also examines implementation challenges in Indonesia, including standardization of medicinal plant materials, quality control, protection against biopiracy, harmonization of national regulations with the Convention on Biological Diversity (CBD) and the Nagoya Protocol, and strengthening the capacity of Health Research Ethics Committees. The study results indicate that the 2016 CIOMS-WHO provides a relevant and adaptive ethical framework for medicinal plant ABM research, but its implementation requires strengthening national regulations, standardizing medicinal plant research methodologies, and protecting the rights of indigenous peoples and biodiversity.

Epidemiological Profile and Contact Patterns of Leprosy in Children Under 15 Years: A Verified Pediatric Evidence Synthesis

2026-09-16T07:42:15+00:00

Leprosy in children under 15 years remains an important epidemiological indicator because it reflects ongoing transmission, delayed diagnosis, or persistent exposure within communities. Understanding pediatric case profiles and contact patterns is essential for strengthening surveillance and early detection strategies. This study aimed to describe the epidemiological profile of pediatric leprosy cases and identify reported contact patterns among children younger than 15 years in an urban Brazilian setting, including age distribution, sex, operational classification, and household or social contact categories. The study employed a verified pediatric evidence synthesis using a publicly accessible full-text study from Salvador, Brazil. Data were extracted from registered pediatric leprosy cases during 2007–2011, focusing on demographic characteristics, clinical classification, and reported exposure categories. The analysis used descriptive frequencies and percentages because the source study did not include a non-case comparison group. Among 145 registered pediatric cases, 76 children were interviewed. Household contact was reported by 52.6% of children, social contact by 25.0%, combined contact by 5.2%, and unknown or no contact by 17.1%. Most cases occurred among children aged 10–14 years (59.3%), while paucibacillary disease represented 60.7% of cases and multibacillary disease 39.3%. The findings highlight the importance of integrated pediatric leprosy surveillance that includes household examination, attention to social and neighborhood exposure, and active case detection. However, the results should be interpreted as descriptive evidence because causal relationships and comparative risks require studies with appropriate control groups.

Determinants of Hospital Information System use Among Inpatient Nurses: The Mediating Role of Training

2026-09-16T07:42:01+00:00

Rapid advances in digital healthcare have increased the need for effective Hospital Information Systems (HIS) to support nursing services, clinical documentation, and hospital management. However, HIS utilization among nurses remains influenced by system performance, information quality, technical support, and user competency. This study aimed to examine the effects of system quality, information quality, and service quality on HIS use among inpatient nurses, with training as a mediating variable. A quantitative explanatory study with a cross-sectional design was conducted among 54 inpatient nurses at RSBHT Hospital using total sampling. Data were collected using a validated and reliable questionnaire and analyzed through descriptive analysis using the Three Box Method and Partial Least Squares Structural Equation Modeling (PLS-SEM) with SmartPLS. The findings showed that system quality and information quality significantly influenced HIS use, whereas service quality did not have a direct significant effect. Furthermore, system quality, information quality, and service quality significantly influenced training, and training demonstrated the strongest effect on HIS use while strengthening the indirect relationships between quality dimensions and system utilization. The study suggests that hospitals should improve HIS usability, information completeness, technical responsiveness, and continuous practice-based training programs to optimize nurses’ adoption and utilization of HIS. These findings highlight the strategic role of training in bridging technological quality and effective HIS implementation in healthcare settings.

Toxico-Epigenomic Mechanisms of Smoking Exposure in Lung Cancer Development

2026-09-16T07:41:33+00:00

Lung cancer remains one of the leading causes of cancer-related mortality worldwide, with cigarette smoking recognized as the primary environmental risk factor contributing to its development. Tobacco smoke contains various carcinogenic compounds that induce oxidative stress and epigenetic alterations, including DNA methylation and histone modifications, which regulate gene expression without altering the DNA sequence. This review aimed to examine the toxico-epigenomic mechanisms underlying smoking-induced lung carcinogenesis, particularly the roles of nicotine-derived nitrosamine ketone (NNK), carbon monoxide, DNA methyltransferases (DNMTs), and chromatin modifications. This study employed a narrative literature review approach by analyzing relevant peer-reviewed scientific publications focusing on tobacco toxicology, epigenetic regulation, and lung cancer mechanisms. The findings indicated that NNK contributes to lung carcinogenesis through DNMT1 stabilization, promoter hypermethylation, and the silencing of tumor suppressor genes, while carbon monoxide promotes hypoxia and reactive oxygen species generation, further enhancing epigenetic dysregulation. These mechanisms influence critical biological processes, including cell proliferation, apoptosis, DNA repair, and tumor progression. Understanding smoking-related epigenetic alterations provides important insights for developing early diagnostic biomarkers and targeted therapeutic strategies, including DNMT inhibitors such as 5-azacitidine, 5-aza-2'-deoxycytidine, and zebularine. This review highlights the importance of integrating toxico-epigenomic approaches to improve understanding and management of smoking-related lung cancer.