Unnes Journal of Public Health starting in 2024 migrates from OJS 2 to OJS 3 to better secure from various unwanted things, including journal hacking and so on. To submit, the author please visit the new website page of our journal at the link https://journal.unnes.ac.id/journals/ujph MIGRATION OFFICIAL STATEMENT HERE Unnes Journal of Public Health is published by Universitas Negeri Semarang (UNNES) in cooperation with the Association of Indonesian Public Health Experts (Ikatan Ahli Kesehatan Masyarakat Indonesia (IAKMI)). Unnes Journal of Public Health contains articles about health epidemiology, biostatistics, health administration, public health nutrition, environmental health, occupational health and safety, health promotion, reproductive health, maternal and child health, health management, health economics, traditional medicine/treatment for preventive or first aid purposes, public health law/ethics and other related health articles, especially in low-income and middle-income countries. The journal can be used by health practitioners, health caregivers, teachers, students, and people who interested in health issues. Indexing GARUDA SINTA DIMENSIONS DOAJ SCOPUS SCIMAGOJR
Universitas Negeri Semarang (UNNES) in cooperation with the Association of Indonesian Public Health Experts (Ikatan Ahli Kesehatan Masyarakat Indonesia (IAKMI))
Wealth Index Association with Elective or Choice of Pre-Labor Caesarean Section among Thai Women
The prevalence of caesarean section in Thailand is increasing every year along with the growing capability of women to work. This study examined the correlation between wealth index and caesarean section decision (decided in advance or after labour). This study used secondary data from the Multiple Indicator Cluster Survey (MICS) Thailand in 2022. The sample consisted of women who had at least one child. The dependent variable is the caesarean section decision, and the main independent variable is the wealth index. The data was analyzed for univariate, bivariate (t-test and Chi-square), and multivariate (binary logistic regression). The findings revealed that around 70% of women decided to deliver by caesarean section in advance (not after labour). The multivariate analysis found the richest women were 2.88 times more likely to decide to deliver by caesarean section in advance compared to lower wealth index quantiles. This study contributed to the current phenomenon that the richest women tend to deliver by caesarean section as an elevated social status compared to vaginal birth.
caesarean section; Thai women; wealth index; MICS Thailand
Copyright (c) 2025 Unnes Journal of Public Health
Health Education to Improve Maternal Awareness on Soy-Based Infant Formula for Individuals with Cow’s Milk Allergy in Indonesia
Background: Cow’s milk allergy is relatively common among Indonesian infants who are not exclusively breastfed. Despite extensive hydrolyzed formula and amino acid-based formula are the recommended nutrition for infants with moderate-tosevere illness, not all parents could provide those specialized formulas, presumably due to the high cost, low availability and poor palatability. In that case, soy-based infant formula could be an alternative nutrition. However, it was unknown whether Indonesian mothers were aware on that alternative nutrition. Objective: We therefore assessed the knowledge levels of mothers who participated in an online platform of PrimaKu on the usefulness of soy-based infant formula to support growth and development of children with cow’s milk allergy. Methods: The study subjects appeared to have sufficient levels of knowledge on the usefulness of soy-based infant formula for children with cow’s milk allergy. Results: In addition, by increasing their knowledge on iron and fiber fortification in soy-based infant formula, e.g., through regular academic presentations, mothers could be more selective in choosing alternative nutrition for children with cow’s milk allergy. Conclusion: Our study suggested that Indonesian mothers who were active in the online platform of Primaku had sufficient levels of knowledge on the usefulness of soy-based protein for managing children with cow’s milk allergy.
cow’s milk allergy; soy-based infant formula; indonesia
Establish The Policy Target to Reduce Stunting Among Indonesian Toddlers with Single Mothers
Single mothers bear two significant burdens: domestic responsibilities and earning an income. The role of a mother determines the nutritional status of a toddler. Until now, policies about stunting have not focused on specific target areas. The study aims to establish a policy target for reducing stunting among Indonesian toddlers with single mothers. The cross-sectional study examined 5,387 toddlers. Eight independent factors were considered: place of residence, mother’s age, occupation, education, socioeconomic status, antenatal care (ANC), children’s age, and sex. A binary logistic regression test was used for data analysis. 20.0% of Indonesian toddlers who had single mothers were stunted. Rural youths were 1.171 times more likely to be stunted (95%CI 1.149-1.192). All maternal ages were more likely to have stunted kids than ≥45. Lower education increases the risk of stunted toddlers. Unemployed mothers were 1.170 times more likely to have stunted kids (95%CI 1.148-1.192). The wealthier the household, the less likely the under-fives are to be stunted. Mothers without ANC were 1.194 times more likely to have stunted toddlers (95%CI 1.116-1.278). Toddlers were more likely than infants (0-11 months) to be stunted, and girls had a higher risk of stunting. The policy targeted rural areas, low-income families with young, uneducated, unemployed mothers, no ANC, older toddlers, and girls.
health policy; nutritional status; public health nutrition; single mother; stunting
Birth Interval and Twins Birth on Maternal Mortality in Indonesia: Cross-Sectional Study
Maternal mortality is a global-scaled health problem to indicate how good a health system is in a region. Indonesia reached 305 per 100.000 live birth as per 2017. That rate is still far from SDGs 2030 which suggests that every country has accomplished 70 per 100.000 livebirth. There are factor risks that caused maternal mortality. Those factors can be divided into individual character-related factors, socioeconomy-related factors, and healthcare-related factors. This study is an analytical study using cross-sectional design data from the DHS program 2017. Data were analyzed using bivariate analysis and multivariate analysis to fiigure out which variables that associate with maternal mortality. Preceding birth interval, succeeding birth interval, and twin birth status are the three main factor risks that associate with maternal mortality. It is recommended that Indonesian family needs to participate in family planning, including birth control in order to control the factor risks of maternal mortality.
determinants; maternal mortality; birth interval; twin birth
Dietary Quality and Body Composition on Lipid Profile in Endurance Athletes Aged 13-18 Years in Central Java Province
Diet quality and body composition are critical determinants of lipid metabolism and cardiovascular health in adolescent athletes. However, the relationship between these factors and lipid profiles in this population remains underexplored. This study aimed to examine the association between anthropometric indicators, diet quality, and lipid profile parameters in adolescent athletes. A cross-sectional study was conducted on 72 adolescent athletes. Univariate analysis described participants’ characteristics, including anthropometric measures, diet quality using the Alternative Healthy Eating Index (AHEI), blood pressure, lipid profiles, and physical activity levels. Data normality was tested using the Kolmogorov–Smirnov test. Pearson or Spearman correlation tests were applied for bivariate analysis, and logistic regression was used for multivariate analysis. Statistical significance was set at p < 0.05. Participants had a mean BMI of 21.9 ± 2.1 kg/m², body fat percentage of 19.3 ± 5.5%, and AHEI score of 51.1 ± 10.6, indicating moderate diet quality. Most lipid parameters were within normal ranges. Bivariate analysis revealed no significant associations between BMI, waist circumference, or AHEI score with lipid parameters. Waist-to-hip ratio was positively associated with HDL (p = 0.017). Body fat percentage showed significant associations with total cholesterol (p = 0.001), HDL (p = 0.001), LDL (p = 0.007), and triglycerides (p = 0.010). Multivariate analysis confirmed body fat percentage as the strongest predictor of lipid profile alterations. Body fat percentage is a more sensitive indicator of lipid metabolism changes than BMI in adolescent athletes.
adolescent athletes; body composition; diet quality; lipid profile
Factors Associated with the Quality of Life of People Living in Saltwater Intrusion Areas
Saltwater intrusion adversely affects both agriculture and mental health, yet its impact on quality of life (QoL) is underexplored. To understand the profound implications of saltwater intrusion on mental health and quality of life (QoL), especially when combined with other stress factors. The study aims to explore this underexplored relationship in saltwater intrusion-affected zones of Thailand. We investigated the QoL of 417 Thai agriculturists in saltwater-affected areas using the WHOQOL-BREF survey and multiple linear regression. Results indicated that a majority, 61.63%, experienced a moderate QoL, and a significant 83.69% reported tasting salinity in their water. A key finding was that individuals aware of their water’s salinity had notably lower QoL scores. Influential factors on QoL included gender, age, household size, education, and occupation. Specifically, the detection of salinity in drinking water was linked to a 3.16-point reduction in QoL scores (Adjusted Mean Difference: -3.16, 95% CI: -5.08 to -1.25). Furthermore, those with an awareness of water salinity saw an additional QoL decrease of 4.40 points (Adjusted Mean Difference: -4.40, 95% CI: -6.84 to -1.96). The findings underscore the urgency for targeted government interventions to address the repercussions of saltwater intrusion. Strategies including the implementation of real-time alert systems and the establishment of protected freshwater reserves are vital for preserving agricultural productivity, ensuring water security, and enhancing the well-being of affected communities.
saltwater intrusion; quality of life; water quality; agriculture; mitigation strategies
Association Between Heat Stress Exposure, Physical Activity, and Nutritional Status with Occupational Fatigue: Pilot Study
Global economic losses from workplace heat and reduced labor productivity are projected to reach nearly US$2 trillion by 2030. The rubber processing industry is particularly vulnerable to heat exposure. This study aimed to describe worker sociodemographic characteristics and assess the relationship between perceived heat stress, nutritional status, physical activity, and occupational fatigue among employees at PT. X in Jambi Province. A cross-sectional design with purposive sampling involved 74 workers across three production areas. Fatigue was measured using the Swedish Occupational Fatigue Inventory (SOFI), while perceived heat stress was assessed with the Heat Stress Perception Index (HSSI). Data were analyzed with univariate and multivariate methods, including multiple linear regression. Participants had a mean age of 34.03 years, BMI of 25.88, and oxygen saturation of 98.01%. The mean heat stress perception score was 50.31, and occupational fatigue averaged 40.55. Lack of energy was the most reported fatigue dimension (mean = 49.23), whereas lack of motivation was the least (mean = 29.92). Regression analysis identified gender (p = 0.003), physical activity (p = 0.031), and perceived heat stress (p = 0.035) as significant predictors. These findings highlight the need for targeted occupational health interventions to mitigate fatigue in the rubber processing industry
worker health; urine specific gravity; occupational fatigue; heat stress; multiple linear regression
Factors of Diabetic Retinopathy among Type 2 Diabetes Mellitus Patients in Central Java Province, Indonesia
One of the microvascular complications of type 2 diabetes mellitus is diabetic retinopathy. The prevalence of diabetes mellitus in Central Java Province in 2022 by 10% increased to 12.52% in the third quarter of 2023. This prevalence rate has not reached the SDG's target, namely there is no increase in diabetes prevalence by 0%. The purpose of this study is to analyze factors associated the incidence of diabetic retinopathy in type 2 DM patients at Central Java Provincial Hospital in 2023. This research is quantitative research with a nested case control study design, using electronic medical record data from the Central Java Provincial Hospital in 2023. The variables in this study were gender, age, education level, employment status, marital status, health insurance status, BMI, DM diet, duration of DM, hypertension, other diseases, current blood glucose, and HbA1c. The analysis used was univariate, bivariate, and multivariate analysis (logistic regression). The results showed that there was association between age ≥70 years (p=0.006), DM diet (p<0.0001, OR=20.914), duration of DM (p=0.003, OR=3.010), hypertension (p=0.013, OR=2.619), other diseases including cataracts (p=0.040, OR=9.00), glaucoma (p=0.007), CHD (p=0.040, OR=9.00), and cardiomegaly (p=0.016), current blood glucose (p=0.045, OR=2.478), and HbA1c (p<0.0001, OR=6.152). DM diet is the most dominant factor associated with diabetic retinopathy in type 2 DM patients.
Sarcopenia in Indonesian Community-Dwelling Elderly: The Prevalence and Influencing Factors within the Primary Care Setting
Determining the prevalence of sarcopenia and identifying associated factors can aid in early detection and treatment among community-dwelling elderly. This study aims to estimate the prevalence of sarcopenia and identify associated factors. This cross-sectional study was conducted in the elderly community within the two areas of Public Health Center, Semarang, Indonesia, through random sampling. Sarcopenia was defined based on the 2019 Asian Working Group for Sarcopenia (AWGS) criteria. Data on socio-demographics, clinical, and functional status were collected and associated factors analyzed using multivariable logistic regression. Of the 153 participants, the prevalence of severe sarcopenia was 50.33%, and overall sarcopenia prevalence was 44.44%. Elderly individuals with severe sarcopenia had a mean age of 69.45, with a higher occurrence in women (79.2%) compared to men. Age (p=0.003; APR: 1.105; 95% CI: 1.035-1.180), toilet type (p=0.002; APR: 4.194; 95% CI: 1.677-10.493), and being female (p=0.049; APR: 2.341; 95% CI: 1.003-5.460) were identified as risk factors for severe sarcopenia. The prevalence of severe sarcopenia is elevated among community-dwelling elderly. Sarcopenia was defined as low muscle mass with low handgrip strength and/or low gait speed. Routine check-ups are needed to detect sarcopenia and its risk factors in primary health care to enable early intervention for sarcopenia in the elderly.
Access to Sanitation and Its Impact on Stunting in Toddlers in EastNusa Tenggara, Indonesia
Background: Stunting is still one of the focuses of health problems in the world. Stunting is caused by many factors, including access to sanitation. Inadequate access to sanitation can cause infectious diseases that impair nutritional absorption in toddlers during digestion, leading to stunting. Objective: This study examines the connection between sanitation access and stunting in East Nusa Tenggara Province along with its confounding variables consisting of access to drinking water, toddler age, gender, and residence. Method: The study design was cross-sectional with a sample size of 4,224 children aged 0-59 months analyzed from the 2023 Indonesian Health Survey (IHS) data. Data were analyzed using univariate, bivariate (ChiSquare test), and multivariate (multiple logistic regression analyses with a risk factor model). Results: Studies showed households with inadequate sanitation access can increase the risk of stunting by 1.56 compared to those with adequate sanitation access. Other factors significantly associated with stunting included toddler age, gender, and residence. The problem of access to sanitation is related to residence and defecation behavior. Conclusion: Increasing indiscriminate defecation behavior can increase exposure to pathogens from feces which can cause diseases such as diarrhea, resulting in malnutrition and stunted growth. To reduce stunting in East Nusa Tenggara Province, the government is suggested to enhance programs to expand access to sanitation, especially in rural areas.
Prevalence of Fear of Falling and Its Association with Frailty Among Community-Dwelling Older Adults in Northern Thailand
Frailty in the elderly population is a known risk factor for common geriatric syndromes, contributing significantly to adverse health outcomes. Therefore, we examined the relationship between prevalence of fear of falling and frailty among older adults. A cross-sectional design was employed, and data were collected through in-person interviews conducted between April and May 2024. Participants were selected through simple random sampling from a total of 409 individuals aged 60 years or older, who were included in the analysis. The fear of falling (FOF) was evaluated using the Short Falls Efficacy Scale International (Short FES-I). Frailty was evaluated using the Thai version of the Simple Frailty Questionnaire (T-FRAIL). The mean age was 69.5 years, and 58.7% were female. The prevalence rates were 47.4% for non-frailty, 39.1% for pre-frailty, and 13.4% for frailty among older adults. Multinomial logistic regression analysis revealed that pre-frail adults had significantly higher odds of high FOF (OR: 5.27; 95% CI: 3.16-8.80, p-value < 0.001), whereas frail adults had significantly higher odds of moderate FOF (OR: 4.37; 95% CI: 1.55-12.32, p-value = 0.005) and high FOF (OR: 17.36; 95% CI: 6.79-44.39, p-value < 0.001) compared to a reference group of non-frail participants. Preventing frailty and pre-frailty among older adults could involve interventions that target various risk factors, such as demographic characteristics, and FOF.
Unlocking the Link: Sleep Deprivation and Cognitive Performance in Working-age Women - A Systematic Review
Background: Sleep deprivation is a prevalent issue among working women, often resulting from a combination of professional, familial, as well as societal demands. Objective: This systematic review aims to summarize the body of research on the effects of sleep deprivation on cognitive function, focusing on working women in particular. Method: A comprehensive search was conducted across several databases to locate pertinent studies released between January 2014 and January 2024. Research has examined the relationship between sleep deprivation and executive function, memory, attention, and decision-making, among other cognitive abilities. The chosen studies' methodological quality was assessed, and relevant data were located and compiled. Results: The results indicate that sleep deprivation has a major negative impact on working women's cognitive function, with deficiencies noted in a number of domains. Age, workload, and family obligations may also increase these effects. Conclusion: To develop targeted therapies that can lessen the detrimental impacts of sleep deprivation and improve the wellbeing of women in the profession, a thorough understanding of how sleep deprivation affects cognitive performance is crucial.
Sleep deprivation, cognitive performance, working women.
Experiences of Working with Parents with Mental Disabilities in Private Education Institutions: A Qualitative Focus Group Study
The purpose of this study is to understand the experiences of parents with intellectual disabilities employees whom working in official private education institutions and the contribution to the scientific field. A qualitative method was used in this research. The study adopted a phenomenological design, highlighting the exploratory nature of qualitative research. Six focus groups were formed in this study. -These six focus group sessions were conducted, with total of 36 participants. Coding analyses were done using the MAXQDA 2022 program. Then,content analyses from the focus groups were conducted focusing to answer the research questions.This study recommended that counseling services should be provided specifically to intellectually disabled parents, focusing particularly specific on the social work profession. In addition, this study recommended for competent authorities to conduct further close monitoring and case follow-ups for involved families to observe the ongoing situations between parents and children.
experiences; intellectual disabilities; private education institution; parents; social work needs
The Relationship Between Burnout and Violence Tendencies of Caregivers of Patients with Schizophrenia
The importance of family has increased with the adoption of the community-based approach in the treatment of patients with schizophrenia and returning them to their social environments. Schizophrenia is a chronic mental illness, that affects not only the individual but also the family’s life because 10% of suffered individuals with illness need such long-term care and needed support from their families. This study aims to examine the relationship between burnout and violent tendencies among caregivers of schizophrenia patients. The study was a correlational and cross-sectional survey and followed quantitative methodology. The population consisted of 60 caregivers who took primary responsibility and spent the most time with patients diagnosed with “schizophrenia” according to DSM-V-TR diagnostic criteria, who were registered in a health center. In line with the purpose of the research, data collection tools are the Personal Information Form, Maslach Burnout Scale, and Violence Tendency Scale. The study found that there was a positive significant relationship between burnout and violence tendency among caregivers (r=0.539; p=0.000<0.05). In other words, burnout of caregivers increases violence tendency. In addition, the sub-dimensions of burnout significantly affected the propensity to violence (F=8,657; p=0.000<0.05). The severity of illness in schizophrenia patients impairs their caregivers’ mental health. Families caring for persons with schizophrenia have difficulty tolerating them if the families have a feeling of burnout. Dissemination of psychosocial practices among caregivers of schizophrenia patients in adjunct to treatment will help families reduce their level of burnout and depression.
Copyright (c) 2024 Unnes Journal of Public Health
Exclusive Breastfeeding as the Foundation for Complementary Feeding: A 2022 Analysis of Nutrition Status Survey (NSS) Lampung Province, Lampung
In Indonesia, supplemental foods are provided to almost 40% of newborns before they are six months old. This study aimed to identify the factors influencing complementary feeding practices in Lampung Province. A cross-sectional design was used, drawing on secondary data from the 2022 Nutrition Status Survey (NSS) of Lampung Province. Data were collected from all districts and cities in the province, consisting of 13 districts and 2 cities, and included children aged 6–23 months. The final sample comprised 2,310 respondents. Data collection involved interviews, anthropometric assessments and physical checks using household and individual questions carried out by qualified local enumerators. The physical examinations assessed nutritional status, including breastfeeding and complementary feeding practices. Anthropometric measurements included body weight, length/height, and mid-upper arm circumference. Multivariate logistic regression was used for data analysis. The results showed that the variable most strongly associated with complementary feeding practices was breastfeeding history (p = 0.001; OR = 2.244; 95% CI: 1.377–3.658). These findings highlight the importance of optimising exclusive breastfeeding up to six months of age, as it supports infants in developing preferences for a wider variety of foods.
complementary feeding; exclusive breastfeeding; nutrition; breast milk
The Effect of Being Faithful, Condom Use, no Drug Behavior on the Incidence of Sexually Transmitted Infections (STIs) in Unmarried Men Who Have Sex with Men (MSM) in Indonesia
Background: “BCD” habits can help homosexual people and men who have sex with men (MSM) prevent the transmission of sexually transmitted infections (STIs) and safeguard their partners. Objective: The purpose of this study was to investigate how BCD behaviour affects the prevalence of STIs among Indonesian MSM. Methods: a cross-sectional study was conducted in 24 provinces in Indonesia from April to May 2023. The study population comprised MSM who had ever engaged in sexual intercourse, either occasionally, once, or frequently, totaling 6,000 individuals. A sample of 3,515 participants was selected using the Respondent Driven Sampling (RDS) method. Integrated Biological and Behavior Survey (STBP) 2018-2019 data was utilized. The data was analyzed using multivariate analyses with STATA 14 software. Results: after controlling for the variables of pieces of information exposure and vaginal intercourse, the following behaviors were found to have a significant influence of the occurrence of STIs among MSM (p-value:0.050; AOR:1,62 with 95% CI:0.96-2.73), condom use (p-value:0.050; AOR:0.37 with 95% CI:0.14- 1.00), no drug use (p-value:0.040; AOR:1,67 with 95% CI:1.02-2.75). Conclusion: promoting faithful behavior towards a steady partner, consistent condom use during sexual activity, and refraining from injections and drug use can effectively reduce the transmission of STIs among MSM.
Healthy Lifestyle Components and Mental Health among Undergraduate Students
Background: Mental health issues among undergraduates have gained attention in recent years due to their rising incidence. Healthy lifestyle components like sleep quality, diet, physical activity, substance abuse, and social support may affect mental health. Thus, recognizing the most important components of a healthy lifestyle allows relevant parties to execute suitable treatments. Objective: This study aims to identify predictors of a healthy lifestyle on mental health. A cross-sectional study was carried out on a randomly selected sample of 180 undergraduate students aged 18 to 30. Significant predictors of healthy lifestyle components were identified using AHLQ and DASS 21 instruments. Methods: This research is quantitative research with a nested case-control study design, using electronic medical record (EMR) data from the Central Java Provincial Hospital in 2023. The variables in this study were gender, age, education level, employment status, marital status, health insurance status, BMI, DM diet, duration of DM, hypertension, other diseases, current blood glucose, and HbA1c. The analysis used was univariate, bivariate, and multivariate analysis (logistic regression). Results: The findings indicate a significant relationship between a healthy diet and mental health, and a healthy diet contributes 25% of variances, while 29% of mental health variance was attributed to the combination of a healthy diet and PA. Furthermore, 31% of mental health variance is attributed to sleep quality variables, and a combination of healthy diet, PA, sleep quality, and substance abuse contributes to 34% of mental health variance. Conclusion: This study provides insights to stakeholders in terms of incorporating healthy lifestyle components in mental health intervention strategies for undergraduate students. It was concluded that such interventions should focus on promoting a healthy diet since it is the most significant measure of good mental health.
Mental Health; Healthy Lifestyle; Depression; Anxiety; Stress
Environmental Health Risk Assessment of Consumption of Foodstuffs Containing Organophosphate Residues among Farmers
The use of pesticides in the agricultural sector results in contamination of foodstuffs by pesticide residues, thus becoming a source of exposure to the body and resulting in health problems. The purpose of this study was to analyse the health risks due to the consumption of foodstuffs containing organophosphate residues in farmers. The design of this study was cross-sectional, employing the Environmental Health Risk Assessment (EHRA). The study population was farmers in the North Dempo District of Pagar Alam. A total of 117 farmers were sampled randomly. Environmental samples consisted of five red chilies and five tomatoes, which were selected purposively. Organophosphate residues were quantified using liquid Chromatography Tandem Mass Spectrometry. Body weight was measured using calibrated body scales. Activity pattern data were collected through interviews using a questionnaire. Data analysis was conducted using the EHRA formulas. The results demonstrated the presence of Chlorpyriphos in red chillies at a concentration of 3,05 mg/kg, while Profenofos was found at 0.0731 mg/kg and 0.0118 mg/kg. The presence of Chlorpyriphos in tomatoes samples at a concentration of 0.4439 mg/kg, while Profenofos was found at 0.0112 mg/kg and 0.2043 mg/kg. The risk quotient for consumption of red chillies containing Chlorpyriphos was found to be 0.0447, while that for Profenofos was 0.2476. The risk quotient for consumption of tomatoes containing Chlorpyriphos was found to be 0.0302, while that for Profenofos was 2.92. It can be concluded that respondents were at non-carcinogenic health risk due to consumption of tomatoes containing Profenofos.
A Systematic Approach Utilizing the System Engineering Initiative for Patient Safety 2.0 Model to Mitigate Fatigue in ER
The study focuses on addressing fatigue among healthcare workers in Emergency Room (ER), vital in delivering health services but prone to worker fatigue. Using objective measures like cardiovascular load (%CVL) and Bourdon Wiersma test, it evaluates physical and mental fatigue. Leveraging the System Engineering Initiative for Patient Safety 2.0 (SEIPS 2.0) model, it comprehensively analyzes factors affecting fatigue. Data collection includes surveys and statistical analysis through Structural Equation Modeling-Partial Least Squares (SEM-PLS). Results show all workers experience fatigue, with physical fatigue affected by age and gender, and mental fatigue influenced by workload. The outer model analysis confirms convergent and discriminant validity, and reliability of the constructs. The inner model analysis reveals the work system significantly affects fatigue, while the process does not. The study emphasizes the importance of addressing fatigue to improve worker well-being and enhance patient care in ER, providing actionable insights for healthcare organizations.
Development of a Mobile App for Smoking Cessation: a Qualitative Study
Smoking is a public health concern in Indonesia. A challenge facing Indonesian healthcare system is that the use rate of in-person smoking cessation counseling is low due to smokers’ concerns about their privacy. This challenge has limited the ability of Indonesian health researchers and policy makers to develop and implement evidence-based practices to prevent smoking. The development of digital technologies in Indonesia has offered various opportunities to address this issue. Mobile devices are ubiquitous in Indonesia and have the potential to deliver counseling services for smokers. This study was part of the Mobile Application System for Smoking Cessation program and aimed to investigate the culturally-tailored features of mobile apps to prevent smoking in Indonesia. Data were collected through structured interviews and Focus Group Discussions (FGDs) among Indonesian policy makers and experts from universities and NGOs. We also reviewed relevant documents recommended by participants. We found that to develop a culturally-tailored mobile app for smoking cessation in Indonesia, it is important to understand smokers’ characteristics, smoking status, smoking behavior, and level of motivation to quitting smoking. We also found that following the World Health Organization’s 5A (Ask, Assess, Advise, Assist, Arrange) and 5R (Relevance, Risk, Reward, Roadblocks, Repetition) strategies is a key to improve the feasibility and acceptability of a smoking-cessation mobile app. App-based interventions need to be integrated with the practices performed by counselors and health workers and should be easily accessed by smokers.
Analysis of Occupational Accidents in Various Informal Sectors in Indonesia
Occupational Safety and Health (OSH) protection is the fundamental right of every worker and a legal component that should be implemented in the workplace, including the informal sector. Many informal sectors in Indonesia still have high potential hazards; including those related to the work environment, chemical substance management, inadequate knowledge of employers and workers, non-compliance with OSH standards, and suboptimal prevention of work-related accidents and illnesses. This study aims to analyze the OSH conditions in the informal sector and their influence on occupational accidents in various informal sectors in Indonesia. The study adopts an analytical observational design with a cross-sectional design, using purposive sampling technique. The selected informal sectors include paint workshops, batik, furniture and salons. An interesting finding from this research indicates that the variable influencing occupational accidents in the informal sector is chemical hazards, with a significance value <0.05, i.e., 0.035, and Exp (B) of 64.188, meaning that workplace chemical hazards affect the occurrence of occupational accidents 64.188 times more. Therefore, intensive supervision and guidance regarding the work environment, especially chemical substance management, must be continuously enhanced.
A New Opportunity Related Hypercholesterolemic and the Improvement of Glucose Levels, Lipid Profiles, and Microbial Activity: Red Dragon Fruit (Hylocereus polyrhizus) Peel Yogurt and Animal Study
Hypercholesterolemia estimated to cause 2.6 million deaths and 29.7 million disability problems. The incidence of Noncommunicable diseases (NCD) such as coronary heart disease (CHD), type 2 diabetes, and some types of cancer can be involved with hypercholesterolemiaed. Red dragon fruit (Hylocereus polyrhizus) peel contains total phenolic compounds, flavonoids and dietary fiber. Red dragon fruit (Hylocereus polyrhizus) peel, which was originally considered as trash can be used to produce yogurt. This study aimed to analyse the effect of red dragon fruit (Hylocereus polyrhizus) peel yogurt on levels of fasting blood glucose, lipid profile and microbial activity in hypercholesterolemic Wistar rats. This was an experimental- research with pre and post-test control group design. A total of 25 male Wistar rats were divided into five groups randomly. Hypercholesterolemic conditions in the Wistar rats were obtained from consuming solution consisted of 1% of cholesterol powder and 0.5% of cholic acid for 14 days. Each Wistar rats received 20 g/day standard feed. The grouping were Group 1 (negative control group); Group 2 (hypercholesterolemic group); Group 3 (1.8 ml/kg b.wt/day of dragon fruit peel yogurt); Group 4 (2.7 ml/kg b.wt/day of dragon fruit peel yogurt); Group 5 (3.6 ml/kg b.wt/day of dragon fruit peel yogurt). The intervention was performed for 28 days. Blood glucose levels and lipid profiles were measured before and after the intervention. Blood glucose, lipid profiles and microbial activity were measured using GOD-PAP, automatic biochemistry analyser and pour plate method respectively. Data were analysed using paired t test and one-way ANOVA. Blood glucose, TC, LDL-C, TG levels were decreased, and the other side HDL-C was increased significantly in the Group dragon fruit peel. There was no difference in the total number of microbes in all groups. Dragon fruit peel yogurt is effective in improving glucose levels and lipid profile of hypercholesterolemic Wistar rats.
Spatial Model of Geographic Distribution of Leprosy Cases in East Java Province, Indonesia
Leprosy is an infectious disease and serious health problem that causes disability. According to the World Report on Disability from the World Health Organization (WHO), leprosy is one of the main causes of disability. It can be transmitted through inhalation or contact with patients, which allows it to spread easily and generally occurs in developing countries, including Indonesia. The number of leprosy cases in Indonesia also fluctuates every year, particularly in East Java Province. This study aimed to apply leprosy spatial modeling by evaluating the heterogeneity of data distribution in East Java Province. Using data from the health profile of the East Java Province, the study analyzed socioeconomic variables, access to health services, and the condition of the home environment. Spatial analysis using Moran’s Index and the Spatial Error Model was employed to obtain spatial distribution and modeling patterns. Variables such as Human Development Index, poverty, access to health centers, and the physical condition of the home environment spatially affect leprosy cases. Cross-sectoral collaboration is needed to address leprosy cases.
Assessment of PM10 Exposure Risk in Communities Downwind and Upwind of Stone Milling Plants in Northeastern Thailand
PM10 particles can be inhaled and absorbed into the bloodstream and lymphatic systems. However, there is a lack of information in Thailand regarding the release of dust from stone mill units and the potential health risks it poses to the surrounding community. The aim of this research is to assess the health risks associated with PM10 exposure for residents of communities surrounding stone milling plants in Northeastern Thailand. The study included a total of 225 households located both downwind and upwind of the stone milling plants. Data were gathered by the conduct of a questionnaire to the participants, as well as the collection of PM10 particulate matter in the specified area. The collection of PM10 was conducted following the established NIOSH method number 0600. The non-carcinogenic attributes of PM10 were analyzed based on the guidelines provided by the Environmental Protection Agency. A descriptive statistical analysis was performed on the collected data to determine various parameters such as frequency, percentage, average, maximum, and minimum values. The mean concentration of PM10 in the downwind community was 0.024796 mg/m3 (S.D. = 0.0551), while in the upwind community it was 0.000232 mg/m3 (S.D. = 0.0002). The community exhibited Hazard Quotient (HQ) values that were considered acceptable, along with lower exposure levels. However, the residents in the surrounding areas of the stone mill may be exposed to dust from a variety of sources, including transportation, construction, and the burning of agricultural material. The current study’s findings are anticipated to provide important information to improve the understanding of PM10exposure in populations living near stone milling plants.
Spatial-Temporal Epidemiology of COVID-19 in Aceh, Indonesia: A Statistical Perspective
The development of COVID-19 cases in Aceh for each region based on spatio-temporal is vital information to know. Spatio-temporal mapping is carried out to know the distribution of cases in diversity based on regional and time conditions. The time series design study was used as the research design in this study. This study aims to obtain factors that influence the incidence of COVID-19 cases in Aceh using panel data regression analysis and the GTWR model for more accurate results. There are nine variables from 23 districts/cities in Aceh Province in 2020 and 2021. Based on partial panel data regression analysis, of the eight independent variables that are factors for analysis, it shows that only the variable number of doctors (p < 0.000), number of Tuberculosis Cases (p < 0.000), Number of Villages with Puskesmas (p < 0.026), and Number of Poor population (p < 0.035) have a significant effect on the increase in COVID-19 cases in Aceh. The number of Tuberculosis Cases is a very dominant variable. Then, the results of the GTWR analysis using the Adaptive Kernel Exponential weighting function show that regional and time diversity affect the factors that cause an increase in COVID-19 cases in Aceh. These factors need to be a concern in controlling COVID-19 cases in Aceh in the future.
Geographically and Temporally Weighted Regression
Risk Factors Of Mortality Among Hajj Pilgrims In SOC 1444 H Group
Hajj is an annual international ritual because it is carried out every year and involves Muslims from various parts of the world. Based on data from Siskohatkes, in 2022 there was a decrease in the number of pilgrims who died, which is 101 pilgrims, while in 2023 there was 8 times increase to 856 pilgrims who died. In 2022, the number of pilgrims with SOC embarkation who died was 19 pilgrims, while there was a significant increase in the number of deaths of pilgrims by approximately 6 times with the number of 129 pilgrims who died. The purpose of this study was to determine the risk factors for death of pilgrims for SOC group. This study is an observational quantitative study with a nested case control research design. This research was conducted in Central Java Province and Yogyakarta Special Region Province during the Hajj period 1444 H (2023). The result is that cardiomegaly (p-value:0,009; OR: 2.058; 95% Cl: 1.195-3.543), disease history (p-value<0.001; OR: 0.242; 95% Cl: 0.155-0.377), overweight and/or obesity (p-value<0.001; OR: 0.460; 95% Cl: 0.302-0.700) have a significant impact on the mortality of the Hajj pilgrims. It is hoped that Semarang Port Health Office can carry out monitoring and give more attention towards pilgrims who have cardiomegaly.
Pregnant Women's Experiences Using a Mobile Application for Iron Supplementation Adherence: A Phenomenological Approach
Iron deficiency anemia is a significant global public health concern that disproportionately affects young children and pregnant women. One effective method for monitoring medication in pregnant women is through mobile applications. This study aims to investigate pregnant women’s experience with iron supplementation adherence management using a mobile application. A qualitative study with a phenomenology approach was conducted among 20 pregnant women and midwives. The qualitative method was used to explore participants’ experience using a maternal application called “MySmart Bumil” to improve pregnant women’s adherence to iron supplements. The study identified four themes: the factors of non-compliance, the motivation for taking iron supplements, and the benefits and the weaknesses of using the application. Mobile app reminders can help pregnant women check medication frequency, remind them to take iron tablets, and build more consistent medication habits. However, some pregnant women found that the reminder was ineffective. Pregnant women thought that the notifications should have alarms to be more effective. The mobile application has the potential to assist health providers in effectively monitoring the health state of pregnancy and improving adherence to iron supplementation
Survival Analysis of the Risk Factors Affecting the Survival Time of Diabetic Patients
This study aimed to analyze the risk factors that affect the survival time of diabetic patients. It used the diabetes health indicators dataset (2015) collected from the American population by the “Centers for Disease Control and Prevention,” United States, through the “Behavioral Risk Factor Surveillance System” in 2015. The dataset comprised 70,692 responses, among which every 320th sample was selected to get the estimated sample size of 221 using the systematic sampling method. The collected data was analyzed through a statistical package for the social sciences (SPSS) software 27.0. The outcomes found that risk factors such as age, high cholesterol, smoking, heavy alcohol consumption, physical activity, high blood pressure, heart disease or attack, general health, serious difficulty in walking or climbing stairs, and stroke were significantly associated with the risk of diabetes. General health was a significant predictor of the risk of diabetes. The estimated survival probability of diabetic patients decreases as their age progresses due to risk factors such as smoking, heavy alcohol consumption, stroke, high blood pressure, and heart disease or attack. Also, it decreases with their age if those patients are physically inactive. These findings highlight that more active strategies are required to comprehensively control risk factors to reduce the burden of diabetes among the general inhabitants.
risk factors; diabetic patients; diabetes; survival analysis; survival time
The Factors Associated with Lack of Access to Health Facilities among Persons of Concern (PoC) during the COVID-19 Pandemic in Nigeria
Persons of Concern (PoC) are people displaced because of natural disasters or conflicts and violence, and they include refugees, asylum seekers, internally displaced persons (IDPs), and returnees. Nigeria is one of the major destinations of PoC in Africa. PoC should have the same rights in any sector, including health access in their destination. However, during the COVID-19 pandemic, about 19% of households faced a lack of access to health facilities in Nigeria. This study examined the factors related to the lack of access to health facilities among PoCs in Nigeria during the COVID-19 pandemic in 2020. Methods: Secondary data from the UNHCR survey, which was conducted in July 2020 among 3,222 households categorized as PoC, was used. Univariate, bivariate, and multivariate analyses were used to assess the factors with the aid of STATA 17 software. Results: Factors such as state of residence, population status, marital status, and gender of household heads were found to have a significant correlation with the lack of access to health facilities in Nigeria. Conclusion: The UNHCR, the Nigerian government, and other stakeholders must work together to ensure all PoCs can access health facilities easily, especially during outbreaks of pandemics and other disasters.
Assesment of Occupational Risks and Health Hazards among Healthcare Workers in A Ghanaian Hospital
Information on measuring risks prevalent among healthcare workers in Ghana and globally is limited. With anecdotal evidence suggesting a high level of occupational injuries among health workers working in a Ghanaian University Hospital, this study was conducted to identify the common hazards faced by the health workers and use the decision matrix risk assessment technique to determine the risks associated with some hazards identified. The study also determined these workers’ knowledge, attitude, awareness, and practices toward occupational health and safety. A triangulation of methods was used. The study used a survey, a review of incident registers, and an expert evaluation. There were a total of 133 participants made up of various health professional groups, with nurses and midwives being the majority (31.6%). Knowledge, attitude, awareness, and practices towards occupational health and safety were high. Knowledge scores were significantly associated with age groups (X2-18.996, p-0.001) and cadre of staff (X2-14.690, p-0.005). Attitude was significantly associated with age groups (X2-10.467, p-0.033), years of working (X2-11.112, p-0.011), and cadre of staff (X2-15.467, p-0.004). Awareness was significantly associated with years of working (X2-8.57, p-0.035). There was a high prevalence of self-reported needle stick injuries. A review of incident registers revealed a high underreporting rate of occupational injuries. Staff were found to be at high risk of musculoskeletal injuries and stress.