Analisa Faktor yang Mempengaruhi Tingkat Fertilitas (TFR) di Provinsi Maluku (Analisa Lanjutan Hasil SKAP 2019)

The purpose of this study was to determine the determinants of the factors causing the high Fertility Rate (TFR), rs that affect the number of children born alive. The data used is SKAP data in 2019, with a respondent of women of childbearing age aged 15-49 years. With the model used is binary logistic regression analysis. The results showed that 12 variables had a significant relationship with live births. Child mortality is the most dominant variable that has a significant effect on the number of children born alive, Recommendations that can be given from the results of this study are to increase the supervision of the Health Office related to strengthening institutional capacity through counseling / communication, information, and education through postponement of marriage age and first birth age programs. first age relationship and education about early childhood sex through adolescent reproductive health counseling in order to increase knowledge, attitudes, and behavior of families and communities to create a quality family.

Comparison of Myocardial Layer-Specific Strain and Global Myocardial Work Efficiency During Treadmill Exercise Stress in Detecting Significant Coronary Artery Disease

BackgroundMyocardial layer-specific strain can identify myocardial ischemia. Global myocardial work efficiency (GWE) based on non-invasive left ventricular (LV) pressure-strain loops is a novel parameter to determine LV function considering afterload. The study aimed to compare the diagnostic value of GWE and myocardial layer-specific strain during treadmill exercise stress testing to detect significant coronary artery disease (CAD) with normal baseline wall motion.MethodsEighty-nine patients who referred for coronary angiography due to suspected of CAD were included. Forty patients with severe coronary artery stenosis were diagnosed with significant CAD, and 49 were defined as non-significant CAD. Stress echocardiography was performed 24 h before angiography. Layer-specific longitudinal strains were assessed from the endocardium, mid-myocardium, and epicardium by 2D speckle-tracking echocardiography. Binary logistic regression analyses were performed to evaluate the association between significant CAD and echocardiographic parameters. A receiver operating characteristic curve was used to assess the capability of layer-specific strain and GWE to diagnose significant CAD.ResultsPatients with significant CAD had the worse function in all three myocardial layers at peak exercise compared with those with non-significant CAD when assessed with global longitudinal strain (GLS). At the peak exercise and recovery periods, GWE was lower in patients with significant CAD than in patients with non-significant CAD. In multivariable binary logistic regression analysis, peak endocardial GLS (OR: 1.35, p = 0.006) and peak GWE (OR: 0.76, p = 0.001) were associated with significant CAD. Receiver operating characteristic curves showed peak GWE to be superior to mid-myocardial, epicardial, and endocardial GLS in identifying significant CAD. Further, adding peak GWE to endocardial GLS could improve diagnostic capabilities.ConclusionsBoth GWE and endocardial GLS contribute to improving the diagnostic performance of exercise stress echocardiography. Furthermore, adding peak GWE to peak endocardial GLS provides incremental diagnostic value during a non-invasive screening of significant CAD before radioactive or invasive examinations.

Prevalence and factors affecting the utilization of antenatal care in rural areas of Southwestern Ethiopia

Background Antenatal care (ANC) is a health care intervention intended to ensure the safety of pregnancy. According to the World Health Organization, at least four ANC visits are recommended for a healthy pregnancy. However, whether this recommended number of visits was followed or not in the rural areas of Southwestern Ethiopia is not known. Therefore, the study aimed to investigate the prevalence of, and the associated factors of ANC utilization by pregnant women in the rural areas of Southwestern Ethiopia. Methods A community-based cross-sectional study design was used in three rural zones. The data were collected from n = 978 women through a structured questionnaire with face-to-face interview. The collected data were analyzed using descriptive statistics and a multiple binary logistic regression model. Results The results showed that 56% of women made the recommended minimum number of ANC visits and the remaining 44% of them underutilized the ANC service. The multiple binary logistic regression model identified zone, marital status of the woman, educational level of the husband, occupation of the husband, knowledge of danger signs of pregnancy, birth interval, source of information, timely visits, and transportation problem to be statistically significant factors affecting the prevalence of ANC visit utilization of women. Bench Maji zone had smaller odds ratio of ANC visit prevalence as compared to Kaffa zone. Women who lived in the rural area of Sheko zone are 2.67 times less likely to utilize ANC visit than those who lived in the rural area of Kaffa zone keeping other variables constant. Conclusion The study results highlight the need to increase the number of ANC visits, and the importance of using an appropriate model to determine the important socio-demographic factors that ANC service providers shall focus on to improve the health of the unborn baby and the mother during pregnancy.

Physical activity of individuals with Parkinson’s in social isolation before and during the pandemic COVID-19

The world has been hit by a pandemic caused by the new coronavirus (COVID 19), which has resulted in government recommendations and measures including social isolation to reduce the spread of the disease. In view of these recommendations, there were drastic changes in lifestyle, impacting the physical and mental health of men and women. Thus, this study aimed to investigate the practice of physical activity, according to sex, in individuals with Parkinson’s disease in social isolation before and during the COVID-19 pandemic. Cross-sectional observational study, based on an online questionnaire validated for individuals with Parkinson’s disease PAFPA/COVID19, in which 156 individuals of both sexes and degrees of the disease (I to V) were allocated, with a mean age of 63.70 ± 11.00 years and from different Brazilian regions. Chi-square, Fisher’s exact and binary logistic regression tests were used. It is observed that 92% of the participants were in social isolation, which caused negative effects on the level of physical activity of the participants, even though most of them doing physical activity online. In addition, it was found that those who participated in specific exercise programs for Parkinson’s disease, are less likely to be insufficiently active, as well as individuals who receive online guidance. Although social isolation is a necessary measure to combat COVID-19, the results show a negative effect of this social isolation on the parameters of physical activity in this population in different regions of Brazil. This suggests that better strategies for health promotion in order to increase levels of physical activity at home are necessary to reduce the physical inactivity lifestyle during the pandemic, in order to prevent diseases associated with social isolation and physical inactivity.

Factors influencing migration and settlement of pastoralists in Nairobi City, Kenya

Pastoralism is globally recognized as the backbone of the economy in the vast arid and semi-arid rangelands. Despite its enormous economic contribution, the system is facing a myriad of challenges, among them, land use and land tenure changes, resulting in diminished grazing land. Accompanying such changes is the conversion of traditional grazing lands into other uses such as settlements, with urbanization being one of the key drivers of pastoral system dynamics. Understanding such dynamics in the face of compounding factors such as frequent droughts linked to climate change is key in guiding policy formulation and interventions aimed at achieving a sustainable pastoral production system. This study investigated factors determining migration and settlement of pastoralists in Nairobi City of Kenya. Data was collected through a snowball sampling approach using semi-structured household questionnaires, focus group discussions (FGDs) and key informant interviews (KIIs) in five Sub-counties of Nairobi City County. A total of 144 household interviews, 6 FGDs and 16 KIIs were conducted to elucidate drivers of urban pastoralism, opportunities and challenges encountered by pastoralists in the city. A binary logistic regression model was used to analyse the determinants of their migration. Results show that search for pasture and water resources, and alternative markets especially during droughts, are the main reasons for pastoralists’ migration to the city. In addition, educated herders were found to be more likely to migrate to the city as they pursue wage employment. Whereas these findings revealed that migration to the city exposes pastoralists to diverse livelihood opportunities, they are equally faced by a number of challenges - mainly road accidents involving livestock, frequent land displacements to pave way for development of real estates, and livestock poisoning from sewage and garbage wastes. There is a need for policy and regulatory interventions to recognize pastoralism alongside other forms of urban farming and addressing challenges facing sustainable pastoral production.

Lower GDNF Serum Level Is a Possible Risk Factor for Constipation in Patients With Parkinson Disease: A Case–Control Study

Background: Constipation is a significant symptom of Parkinson's disease (PD). Glial-derived neurotrophic factor (GDNF) is important for the morphogenesis of the enteric nervous system and plays a critical role in the preservation of mucosal integrity under enteric glia surveillance. The aim of this work was to evaluate the serum levels of GDNF in patients with PD with and without constipation.Methods: This work included 128 patients with PD. The patients were classified into three groups: those with PD but no constipation (nCons-PD) (n = 49), those with prodromal stage constipation (Cons-Pro-PD) (n = 48), and those with clinical stage constipation (Cons-Clinic-PD) (n = 31). The association between serum GDNF concentration and constipation was explored using logical regression.Results: The nCons-PD group's mean GDNF levels were 528.44 pg/ml, which was higher than the Cons-Pro-PD group's 360.72 pg/ml and the Cons-Clinic-PD group's 331.36 pg/ml. The results of binary logistic regression indicated that GDNF was a protective factor in the prevention of constipation. Cons-Clinic-PD group had a higher score of MDS-UPDRS-II, MDS-UPDRS-III, MDS-UPDRS-IV, and a higher H-Y staging as compared with nCons-PD group. Relative to the nCons-PD group, Cons-Clinic-PD had higher NMSS scores, lower MoCA and PDSS scores, and were more likely to have RBD.Conclusions: GDNF serum levels are lower in patients with PD who are constipated. A low GDNF level is a potential risk factor for constipation in patients with PD.

The Association Between Dietary Antioxidant Micronutrients and Cardiovascular Disease in Adults in the United States: A Cross-Sectional Study

Background: Antioxidant micronutrients represent an important therapeutic option for the treatment of oxidative stress-associated cardiovascular diseases (CVDs). However, few studies have evaluated the relationship between the levels of multiple dietary antioxidants and CVDs.Objective: The study therefore aimed to evaluate associations between dietary antioxidants and total and specific CVDs among a nationally representative sample of adults in the US.Design: In total, 39,757 adults (>20 years) were included in this cross-sectional study from the 2005–2018 National Health and Nutrition Examination Survey. We analyzed dietary recall of 11 antioxidant micronutrients in this population. Multivariate logistic and weighted quantile sum (WQS) regression were both applied to examine the relationships between these antioxidants, alone and in combination, with the prevalence of all CVDs and specific CVDs. The linearity of these correlations was also explored using restricted cubic spline (RCS) regression.Results: Multivariate logistic models showed that, compared with the lowest quartile, the levels of 11 antioxidants in the highest quartile were independently associated with decreased total CVD (all P < 0.05). The WQS index showed that, when considered together, the 11 micronutrients were negatively correlated with total CVD (P < 0.001) and five specific CVDs (all P < 0.05), and selenium had the strongest association (weight = 0.219) with total CVD. Moreover, the RCS model demonstrated that iron, zinc and copper were all negatively and non-linearly correlated with total CVD, while the eight other micronutrients had non-significant, linear, negative relationships with total CVD (P for non-linearity >0.05). A piecewise binary logistic regression analysis showed that the inflection points in the relationships between CVD and iron, zinc and copper were 7.71, 6.61, and 0.74 mg/day, respectively.Conclusions: Our findings suggested that high levels of combined dietary antioxidant micronutrients are associated with decreased prevalence of CVDs, and that selenium has the greatest contribution to this association.

An exploration of the consequences of, and coping with loneliness in an ageing intellectual disability population

Background: Loneliness has been associated with hypervigilance and sad passivity. The physiological and psychological reactions of people with an intellectual disability to loneliness have never been investigated. This research aims to explore the outcomes of loneliness for an ageing intellectual disability population. Methods: In Ireland, data from a nationally representative data set of people aged over 40 years with an intellectual disability (N=317) was applied to a social environment model that describes the effects of loneliness in five pre-disease pathways health behaviours, exposure to stressful life events, coping, health and recuperation. The data was tested through chi-squared, ANCOVA and binary logistic regression. Results: Being lonely predicted raised systolic blood pressure (A.O.R=2.051, p=0.039), sleeping difficulties (AOR=2.526, p=0.002) and confiding in staff (AOR=0.464 p=0.008). Additionally, participants who did moderate activity had significantly higher loneliness scores (F=4.171, p<0.05). Conclusions: The analysis supports the concept of hypervigilance in older people with an intellectual disability and limited support for the use of coping mechanisms that differ from those found in the wider population. Future research needs to investigate the longitudinal relationships between loneliness and health.

Assessment of COVID-19 vaccines acceptance in the Lebanese population: a national cross-sectional study

Background Vaccines have become the best weapon for epidemic prevention and control in the absence of standard approved effective therapies. However, skepticism about the vaccine efficacy and safety is constantly reported. To our knowledge, there has been no study assessing COVID-19 vaccine acceptance in Lebanon. The primary objective of this survey is to assess the COVID-19 vaccines’ acceptance and its related determinants in the Lebanese population. Methods A cross-sectional study was conducted in Lebanon from February 16 through February 25, 2021. Data was collected using an online questionnaire via social media platforms using the snowball technique. The questionnaire consisted of 47 questions related to sociodemographic and medical history, COVID-19 experience, knowledge, practice, and beliefs towards COVID-19 vaccines, including vaccines acceptance. Binary logistic regression was performed to identify factors associated with vaccine acceptance. Results A total of 1209 questionnaires were completed; around 63.4% have reported their acceptance for receiving the COVID-19 vaccine, while only 57% of participants registered themselves on the national platform. The multivariable analysis showed that a higher knowledge scale, living in an urban residential area, having hypertension, not having a food allergy, reporting a higher fear to experience COVID-19 infection, and receiving or wanting to receive influenza vaccine, were positive predictors of COVID-19 vaccines acceptance. Conclusions Our findings support the need to improve knowledge about COVID-19 infection and vaccination through education and awareness programs. Specifically residents of rural areas should be targeted to optimize COVID-19 vaccine acceptance among the Lebanese population.

Vaccination against COVID-19: Factors That Influence Vaccine Hesitancy among an Ethnically Diverse Community in the UK

The UK’s minority ethnic population, despite being at higher risk of COVID-19 and experiencing poorer health outcomes, continue to have lower uptake of the COVID-19 vaccine compared with their white British counterparts. Given the importance of the vaccination programme in improving health outcomes, this research sought to examine the influential factors that impact the decision to accept the COVID-19 vaccination among an ethnically diverse community. A total of 1058 residents from Luton, UK, a large town with an ethnically diverse population, completed a community survey. Questions centred around uptake or individuals’ intentions to accept the offer of COVID-19 vaccination alongside demographics, knowledge, and views on the vaccine. A binary logistic regression analysis was conducted to determine the most significant predictors of vaccine hesitancy, while respondents’ reasons for not getting vaccinated were identified using qualitative content analysis. Findings revealed that age and ethnicity were the only sociodemographic factors to predict vaccine hesitancy. Knowledge of symptoms and transmission routes, alongside ensuring information about COVID-19 was objectively sourced, were all identified as protective factors against vaccine hesitancy. Qualitative analysis revealed that ‘lack of trust in government/authorities’ and ‘concern of the speed of vaccine development’ were the most common reasons for non-uptake. This research reinforces the importance of age, ethnicity, and knowledge as influential factors in predicting vaccine hesitancy. Further, this study uncovers some of the barriers of uptake that can be utilised in developing promotional campaigns to reduce vaccine hesitancy in certain sections of the diverse UK population.