scholarly journals Dynamically borrowing strength from another study through shrinkage estimation

2019 ◽  
Vol 29 (1) ◽  
pp. 293-308 ◽  
Author(s):  
Christian Röver ◽  
Tim Friede
Keyword(s):  
Controlled Trial ◽  
Meta Analysis ◽  
Randomized Study ◽  
Random Effect ◽  
Model Specification ◽  
Small Scale ◽  
Sources Of Information ◽  
Recent Trial ◽  
Modeling Framework ◽  
Clinical Registry

Meta-analytic methods may be used to combine evidence from different sources of information. Quite commonly, the normal–normal hierarchical model (NNHM) including a random-effect to account for between-study heterogeneity is utilized for such analyses. The same modeling framework may also be used to not only derive a combined estimate, but also to borrow strength for a particular study from another by deriving a shrinkage estimate. For instance, a small-scale randomized controlled trial could be supported by a non-randomized study, e.g. a clinical registry. This would be particularly attractive in the context of rare diseases. We demonstrate that a meta-analysis still makes sense in this extreme case, effectively based on a synthesis of only two studies, as illustrated using a recent trial and a clinical registry in Creutzfeld-Jakob disease. Derivation of a shrinkage estimate within a Bayesian random-effects meta-analysis may substantially improve a given estimate even based on only a single additional estimate while accounting for potential effect heterogeneity between the studies. Alternatively, inference may equivalently be motivated via a model specification that does not require a common overall mean parameter but considers the treatment effect in one study, and the difference in effects between the studies. The proposed approach is quite generally applicable to combine different types of evidence originating, e.g. from meta-analyses or individual studies. An application of this more general setup is provided in immunosuppression following liver transplantation in children.

A Meta-Analysis on the Effectiveness of Prenatal Yoga in Reducing Cortisol Hormone in Pregnancy

2020 ◽  
Author(s):  
Shiva Aflahiyah ◽  
◽  
Didik Gunawan Tamtomo ◽  
Hanung Prasetya ◽  
◽  
...  
Keyword(s):  
Pregnant Women ◽  
Cortisol Level ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Well Being ◽  
The Body ◽  
Inclusion Criteria ◽  
In Pregnancy

ABSTRACT Backgrund: A growing body of evidence suggests that activity of the stress-responsive hypothalamic-pituitary-adrenal axis and its end-product cortisol also may be associated with perinatal emotional well-being. A number of preventive interventions, such as Yoga, targeting psychosocial and physiological risk factors for perinatal depression have utilized mind-body practices, which embody the idea that the mind interacts with the body to influence physical functioning, improve symptoms, and promote health. This study aimed to investigate effectiveness of prenatal yoga in reducing cortisol hormone in pregnancy Subjects and Method: This was a meta-analysis and systematic review. This study collected published articles during 2000 to 2020 from PubMed, Science Direct, Springer, Proquest, and Chocrane electronic databases. The inclusion criteria were full text, randomized controlled trial, and prenatal yoga intervention. The study subjects were pregnant women who received prenatal yoga for 8 to 20 weeks. Outcome was cortisol hormone reduction during pregnancy. The selected articles were analyzed by PRISMA flow chart and RevMan 5.3. Results: 5 articles from America and Asia were met the inclusion criteria. This study had high heterogeneity (I2=88%; p<0.001). Therefore, this study used random effect model (REM). Prenatal yoga reduced cortisol level 0.59 times in pregnancy (Mean Difference= -0.59; 95% CI= 1.18 to 0.01; p= 0.050). Conclusion: Prenatal yoga is effective to reduce cortisol level in pregnant women. Keywords: prenatal yoga, cortisol hormone, pregnant women Correspondence: Shiva Aflahiyah. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: [email protected]. DOI: https://doi.org/10.26911/the7thicph.05.47

scholarly journals Reducing Stress, Anxiety, and Depression for NICU Parents

2021 ◽  
Author(s):  
Amy Patton ◽  
Kylie Dunavan ◽  
Kyla Key ◽  
Steffani Takahashi ◽  
Kathryn Tenner ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Neonatal Intensive Care ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Anxiety And Depression ◽  
Small Scale ◽  
Phase Lag ◽  
Randomized Controlled ◽  
Reducing Stress

This project aims to appraise evidence of the effectiveness of various practices on reducing stress, anxiety, and depression among parents of infants in the neonatal intensive care unit (NICU). The project contains six research articles from both national and international journals. Study designs include one meta-analysis, one randomized controlled trial, one small scale randomized controlled trial, one prospective phase lag cohort study, on pretest-posttest study, and one mixed-methods pretest-posttest study. Recommendations for effective interventions were based on best evidence discovered through quality appraisal and study outcomes. All interventions, except for educational programs and Kangaroo Care, resulted in a statistically significant reduction of either stress, anxiety, and/ or depression. Family centered care and mindfulness-based intervention reduced all barriers of interest. There is strong and high-quality evidence for the effect of Cognitive Behavioral Therapy on depression, moderate evidence for the effect of activity-based group therapy on anxiety, and promising evidence for the effect of HUG Your Baby on stress.

scholarly journals A meta-analysis of prospective studies comparing the results of laminoplasty and laminectomy with instrumental fixation in the surgical treatment of patients with multilevel degenerative cervical spine diseases

2020 ◽  
Vol 75 (1) ◽  
pp. 54-68
Author(s):  
Vadim A. Byvaltsev ◽  
Andrey A. Kalinin ◽  
Marat A. Aliev ◽  
Valeriy V. Shepelev ◽  
Bobur R. Yusupov ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Cervical Spine ◽  
Surgical Treatment ◽  
Perioperative Complications ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Random Effect ◽  
Cochrane Library ◽  
Continuous Variables ◽  
Degenerative Diseases

Background: Dorsal decompressive-stabilizing techniques laminotomy with laminoplasty (LP) and laminectomy with instrumental fixation (LF) are effective methods for surgical treatment of patients with multi-level degenerative diseases of the cervical spine. At the same time, there is currently no priority in determining the optimal method for posterior decompression and stabilization. Aim: conduct a comparative analysis of intraoperative parameters, clinical outcomes, radiological results and complications of LP and LF in the treatment of patients with multilevel degenerative diseases of the cervical spine. Methods: A meta-analysis of prospective cohort clinical trials was carried out, the primary sources were searched using the databases PubMed, CNKI, eLibrary and the Cochrane Library, published until March 2019, which compared the results of applying the LP and LF methods in the treatment of patients with multilevel degenerative diseases of the cervical spine. For dichotomous variables, the relative risk and the 95% confidence interval were calculated; in turn, for the continuous variables, the standardized difference of the mean values and their 95% confidence intervals were used, using random effect models and a fixed effect. Resuts: The meta-analysis included 6 prospective clinical trials, one of which was a randomized controlled trial. In total, the results of surgical treatment of 493 patients with multilevel degenerative diseases of the cervical spine were evaluated. In the group of drugs, statistically significantly smaller parameters of the duration of surgical intervention were verified (p 0.00001). At the same time, comparable parameters of cervical lordosis after surgery, the level of pain in the cervical spine, functional status according to NDI and JOA after surgery, the frequency of perioperative complications (p = 0.17, p = 0.05, p = 0.94, p = 0.96, p = 0.24, respectively). Conclusions: A meta-analysis showed that the functional outcomes of LP and LF, as well as instrumental results in the treatment of multilevel degenerative diseases of the cervical spine, are not clinically significant. In this case, the LP technique can be performed in a shorter period of time compared with LF.

Adjuvant radiotherapy versus wait-and-see strategy for pathologic T3 or margin-positive prostate cancer: A meta-analysis.

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 19-19 ◽  
Author(s):  
Mohammad Parvez Shaikh ◽  
Matthew M. Harkenrider ◽  
Meng-Jia Wu
Keyword(s):  
Prostate Cancer ◽  
Adjuvant Radiotherapy ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Random Effect ◽  
Fe Model ◽  
Medline Search ◽  
Gu Toxicity ◽  
Wait And See ◽  
Margin Positive

19 Background: Optimal management after radical prostatectomy (RP) remains controversial in patients with pathologic T3 or margin-positive prostate cancer with the options being early adjuvant radiotherapy (ART) versus wait-and-see (WS). Methods: A comprehensive Medline search to identify randomized controlled trial (RCT) of ART vs WS was done. Synthesized results from the included studies show Metastasis-Free Survival (MFS) and overall survival (OS) rates at 10 years as well as Grade 2 or greater GI and GU toxicities in the studies. Results were based on the random-effect (RE) model if there was evidence of between-trial heterogeneity, otherwise the fixed-effect (FE) model was used. Results: A total of 3 RCTs (ARO9602/AUO AP09/95, EORTC22911, SWOG8794) were identified with 1,737 patients (ART: n=864, WS: n=873). 10-year estimates of MFS and OS rates were reported for SWOG and EORTC studies, and estimated for ARO 96-02/AUO AP09/95 study from their Kaplan-Meier curves (Table). Pooled 10-year MFS data showed a significant improvement with ART vs WS (OR= 0.77; 95% CI 0.62–0.96, p=0.02, FE). However, pooled 10-year OS was not significantly different (OR= 0.98; 95% CI 0.64–1.49, p=0.91, RE). Grade 2 or greater GI toxicity was reported by all three studies and was significantly higher in ART (2.5%) compared with WS (1.1%), p=0.04. Grade 2 or greater GU toxicity was reported by ARO9602 and EORTC studies and was significantly higher in ART (17.1%) compared with WS (10.3%), p=0.0004. Conclusions: 10-year MFS is significantly improved with ART compared with WS. No benefit in 10-year OS was found. Grade 2 or greater GI and GU toxicities where greater in ART compared with WS. [Table: see text]

scholarly journals The Effectiveness of Web-Based Health Promotion Intervention on Fruits Consumption in Children in America, Australia, And Europe

2020 ◽  
Author(s):  
Sinar Perdana Putra ◽  
◽  
Yulia Lanti Retno Dewi ◽  
RB. Soemanto RB. Soemanto ◽  
◽  
...  
Keyword(s):  
Health Promotion ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Internet Technology ◽  
Health Promotion Intervention ◽  
Web Based ◽  
Consumption Behavior ◽  
Central Java

Background: Internet-based interventions for multiple health behavior appear to be promising in changing unhealthy behaviour, such as low fruits consumption in adolescents. In addition, the use of internet technology is particularly relevant to children and adolescents, who are the major users of such technology. This study aimed to examine the effectiveness of web-based health promotion intervention on fruits consumption in children in America, Australia, and Europe. Subjects and Method: This was a meta-analysis and systematic review. The study was conducted by collect the published articles from PubMed, Science Direct, Research Gate, and Google Scholar electronic databases, from 2013 to 2020. The inclusion criteria were full text, randomized controlled trial (RCT), and web-based health promotion intervention. The study subject was children aged 2-6 years. The study outcome was fruits consumption. The articles were analyzed by PRISMA flow chart and Revman 5.3 program. Results: 6 articles had high heterogeneity between experiment groups (I2= 96%; p<0.001). Therefore, this study used random effect model (REM). Web-based health promotion intervention increased fruits consumption behavior 0.64 times in children (Mean Difference= 0.64; 95% CI= 0.07 to 1.20; p= 0.030). Conclusion: Web-based health promotion intervention increases fruits consumption behavior. Keywords: web-based health promotion intervention, fruit intake Correspondence: Sinar Perdana Putra. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile : +6285727777227. DOI: https://doi.org/10.26911/the7thicph.02.47

Abstract 17265: Comparing Ultrasound Guided and Conventional Method of Venipuncture for Electrophysiological Procedures: A Meta-Analysis

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_1) ◽  
Author(s):  
Udit Joshi ◽  
Sisir Siddamsetti ◽  
Sagar Ranka ◽  
Harsh Rawal ◽  
Jai Parekh ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Conventional Method ◽  
Odds Ratio ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Vascular Complications ◽  
Steady Increase

Introduction: There has been steady increase in the number of catheter ablations for the definitive management of atrial fibrillation and it is associated with its own complications with vascular complications being the most common. There are many studies comparing Ultrasound (US) guided versus Conventional Method (CM) of venipuncture for complications as these patients are on therapeutic anticoagulation. We conducted a meta-analysis to look for any difference between the two approaches. Methods: PubMed, Medline, EMBASE and Cochrane databases were analyzed from inception to January 2018 for all studies comparing US vs CM for venipuncture in patients undergoing catheter ablation. Four observational studies and one Randomized Controlled Trial (RCT) with 5158 patients were studied for major and minor vascular complications. Major vascular complications included hematoma/major bleeding (more than or equal to BARC2), AV fistula and pseudo aneurysm. Random effect model was used to estimate the odds ratio of dichotomous outcomes Results: Major and minor vascular complications were significantly less with US guided approach as compared to conventional approach {Odds Ratio (OR): 0.36, 95% CI 0.21-0.61, P=0.0002} and {Odds Ratio (OR): 0.30, 95% CI 0.15-0.64, P=0.002} respectively. Conclusion: Real time ultrasound use for venipuncture access is safer approach with significantly lesser vascular complications in patients with atrial fibrillation on anticoagulation undergoing catheter ablation.

scholarly journals The Treatment of Acne with the Addition and Subtraction of Loquat Qingfei Yin: A Meta-Analysis

2021 ◽  
Vol 5 (4) ◽  
pp. 167-176
Author(s):  
Wenjun Xue ◽  
Pengguang Xu
Keyword(s):  
Large Scale ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Cochrane Collaboration ◽  
Effective Rate ◽  
Cochrane Library ◽  
Control Group ◽  
Comprehensive Collection

Objective: To systematically evaluate the efficacy and safety of Loquat Qingfei Yin (LQFY) in the treatment of acne. Methods: Using computer retrieval, comprehensive collection of the full text database of Chinese journals till December 2020 (CNKI), Wanfang Data Knowledge Service Platform (Wanfang), Viper Database (VIP), PubMed, Cochrane Library, Medline were included in the LQFY addition or subtraction treatment of acne randomized controlled trial (RCT). Screening of the literatures included in the Note Express 3.2.0. Assessment of the risk of bias in trials using Cochrane collaboration tools, and used Rev Man 5.3 to evaluate the curative effect. Results: 25 RCT, all in Chinese, there were 2257 cases. Of the 1216 cases who were treated, control group was 1041 cases. A random effect model was used for Meta analysis. The results showed that the effective rate of the treatment group was significantly higher than that of the control group, Differences were statistically significant (P=0.94, I2=0%), RR=2.87, CI [2.25,95 per cent 3.67], P<0.00001. Conclusion: There are limited evidence that LQFY is safe and effective in treating acne. However, this conclusion needs to be confirmed by a more large-scale, multi-center, high-quality RCTs.

scholarly journals Day 5 versus Day 6 blastocyst transfers: a systematic review and meta-analysis of clinical outcomes

2019 ◽  
Vol 34 (10) ◽  
pp. 1948-1964 ◽  
Author(s):  
Mathilde Bourdon ◽  
Khaled Pocate-Cheriet ◽  
Astri Finet de Bantel ◽  
Veronika Grzegorczyk-Martin ◽  
Aureli Amar Hoffet ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Outcomes ◽  
Live Birth ◽  
Data Extraction ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Random Effect ◽  
Clinical Pregnancy ◽  
Cochrane Library ◽  
Significant Difference

Abstract STUDY QUESTION Is there a difference in clinical pregnancy and live birth rates (LBRs) between blastocysts developing on Day 5 (D5) and blastocysts developing on Day 6 (D6) following fresh and frozen transfers? SUMMARY ANSWER D5 blastocyst transfers (BTs) present higher clinical pregnancy and LBRs than D6 in both fresh and frozen transfers. WHAT IS KNOWN ALREADY BT is increasingly popular in assisted reproductive technology (ART) centers today. To our knowledge, no meta-analysis has focused on clinical outcomes in both fresh and frozen BT. Concerning frozen blastocysts, one meta-analysis in 2010 found no significant difference in pregnancy outcomes between D5 and D6 BT. Since then, ART practices have evolved particularly with the wide use of vitrification, and more articles comparing D5 and D6 BT cycles have been published and described conflicting results. STUDY DESIGN, SIZE, DURATION Systematic review and meta-analysis of published controlled studies. Searches were conducted from 2005 to February 2018 on MEDLINE and Cochrane Library and from 2005 to May 2017 on EMBASE, Eudract and clinicaltrials.gov, using the following search terms: blastocyst, Day 5, Day 6, pregnancy, implantation, live birth and embryo transfer (ET). PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 47 full-text articles were preselected from 808 references, based on title and abstract and assessed utilizing the Newcastle–Ottowa Quality Assessment Scales. Study selection and data extraction were carried out by two independent reviewers according to Cochrane methods. Random-effect meta-analysis was performed on all data (overall analysis) followed by subgroup analysis (fresh, vitrified/warmed, slow frozen/thawed). MAIN RESULTS AND THE ROLE OF CHANCE Data from 29 relevant articles were extracted and integrated in the meta-analysis. Meta-analysis of the 23 studies that reported clinical pregnancy rate (CPR) as an outcome, including overall fresh and/or frozen ET cycles, showed a significantly higher CPR following D5 ET compared with D6 ET (risk ratio (RR) = 1.27, 95% CI: 1.15–1.39, P < 0.001). For CPR, calculated subgroup RRs were 2.38 (95% CI: 1.74–3.24, P < 0.001) for fresh BT; 1.27 (95% CI: 1.16–1.39, P < 0.001) for vitrified/warmed BT; and 1.15 (95% CI: 0.93–1.41, P = 0.20) for slow frozen/thawed BT. LBR was also significantly higher after D5 BT (overall RR = 1.50 (95% CI: 1.32–1.69), P < 0.001). The LBR calculated RRs for subgroups were 1.74 (95% CI: 1.37–2.20, P < 0.001) for fresh BT; 1.38 (95% CI: 1.23–1.56, P < 0.001) for vitrified/warmed BT; and 1.44 (95% CI: 0.70–2.96, P = 0.32) for slow frozen/thawed BT. Sensitivity analysis led to similar results and conclusions: CPR and LBR were significantly higher following D5 compared to D6 BT. LIMITATIONS, REASONS FOR CAUTION The validity of meta-analysis results depends mainly on the quality and the number of the published studies available. Indeed, this meta-analysis included no randomized controlled trial (RCT). Slow frozen/thawed subgroups showed substantial heterogeneity. WIDER IMPLICATIONS OF THE FINDINGS In regards to the results of this original meta-analysis, ART practitioners should preferably transfer D5 rather than D6 blastocysts in both fresh and frozen cycles. Further RCTs are needed to address the question of whether D6 embryos should be transferred in a fresh or a frozen cycle. STUDY FUNDING/COMPETING INTEREST(S) This work was sponsored by an unrestricted grant from GEDEON RICHTER France. The authors have no competing interests to declare. REGISTRATION NUMBER CRD42018080151.

A systematic review and meta-analysis of the safety of Hydroxychloroquine in a randomized controlled trial and observational studies

2021 ◽  
Vol 16 ◽  
Author(s):  
Mahanjit Konwar ◽  
Miteshkumar Maurya ◽  
Urmila M. Thatte ◽  
Nithya J. Gogtay ◽  
Debdipta Bose
Keyword(s):  
Systematic Review ◽  
Active Treatment ◽  
Observational Studies ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Random Effect ◽  
Safety Data ◽  
Total Sample ◽  
Randomized Controlled ◽  
Newcastle Ottawa Scale

Introduction: Hydroxychloroquine (HCQ) has recently become the focus of attention in the current COVID-19 pandemic. With an increase in the off-label use of HCQ, concern for the safety of HCQ has been raised. We, therefore, performed this systematic review to analyze the safety data of HCQ against placebo and active treatment in various disease conditions. Methods: We searched PubMed, Embase, and Cochrane for Randomized Controlled trials (RCTs) and Observational studies (OSs) that evaluated HCQ for the treatment of any disease other than COVID19 in adult patients up to May 2020. We assessed the quality of the included studies using Risk of Bias 2 (for RCTs) and Newcastle–Ottawa Scale (for OSs). Data were analyzed with random-effect meta-analysis. Sensitivity and subgroup analyses were performed to identify heterogeneity. Results: A total of 6641 studies were screened, and 49 studies (40 RCTs and 9 OSs) with a total sample size of 35044 patients were included. The use of HCQ was associated with higher risks of TDAEs as compared to placebo/no active treatment [RR 1.47, 95%CI 1.03-2.08]. When HCQ was compared with active treatments, the risks of AEs [RR 0.74, 95% CI 0.63-0.86] and TDAEs were less in the HCQ arm [RR 0.57, 95% CI 0.39-0.81]. The outcomes did not differ in the sensitivity analysis. Conclusion: The results suggest that the use of HCQ was associated with a lower risk of AEs and TDAEs as compared to active treatment, whereas posing higher risk of TDAEs as compared to placebo.

scholarly journals The Effect of Foot Orthosis Use in Reducing Pain in Patients with Plantar Fasciitis: A Meta-Analysis

2020 ◽  
Vol 5 (3) ◽  
pp. 309-319
Author(s):  
Atika Febri Anggriani ◽  
◽  
Agus Kristiyanto ◽  
Setyo Sri Rahardjo ◽  
◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Plantar Fasciitis ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Random Effect ◽  
The Elderly ◽  
Pain Reduction ◽  
Randomized Controlled ◽  
Plantar Fasciopathy ◽  
Foot Orthosis

Background: Plantar fasciitis is an inflammatory problem that occurs in the foot area that causes pain. Its prevalence rates range from 4% to 7% in the elderly population, 8% in athletes and up to 25% in runners. One of the treatments used to reduce the degree of pain is the use of foot orthosis. A number of related articles stated that the use of foot orthosis can reduce the degree of pain in plantar fasciitis patients. The purpose of this study was to estimate the magnitude of the effect of using foot orthosis on pain reduction in plantar fasciitis patients by conducting a meta-analysis on the same number of articles. Subjects and Method: The meta-analysis was carried out by systematically reviewing the same number of articles from PubMed, Science Direct, and Google Scholar. By using the search keywords "foot orthosis" OR "FO" AND "custom foot orthosis" AND "foot pain" AND "plantar fasciitis" AND "plantar fasciopathy" AND "effect foot orthosis for plantar fasciitis" AND "treatment for plantar fasciitis" A "randomized controlled trial". The intervention given was the use of a foot orthosis with a comparison without using a foot orthosis with the study subject of plantar fasciitis patients. The study outcome was pain reduction. The article used is a full text article with a randomized controlled trial design that reports the value of the effect size (mean and standard deviations). Articles were collected using the PRISMA flow chart and analyzed using the Review Manager 5.3 application with random effect models. Results: A meta-analysis of 7 randomized controlled trial studies from Brazil, Virginia, Turkey, Germany, China, and Australia suggested that the use of foot orthosis was -0.54 times better at reducing pain in plantar fasciitis patients compared to those without foot orthosis (ES= -0.54; 95% CI -1.11 to 0.03; p= 0.06). Heterogeneity I2= 82%. Conclusion: Foot orthosis reduces pain in plantar fasciitis patients compared to those without foot orthosis Keywords: Plantar fasciitis, pain, foot orthosis Correspondence: Atika Febri Anggriani, Masters Program in Public Health. Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: [email protected]. Mobile : 085728794960

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