The Effect of Nutritional Education with Leaflet and Diet Application on Nutritional Status Changes in Obese College Students

Obesity is excessive body fat condition due to differences in energy consumption and expenditure. In Indonesia, the prevalence of obese women >18 years old is 32.9%. Interventions are performed with control eating and increased physical activity through an educational approach. A Leaflet is a print media containing some information, while my weight loss diet application is used by people that want to lose weight. Therefore, this study aims to determine the effect of nutritional education with leaflet and my weight loss diet application on nutritional status changes in obesity. True experimental design was used with pre-post test on female students divided into two groups in Universitas Brawijaya (n= 44) and selected by purposive sampling. Also, Independent-Samples T-Test and Mann Whitney analysis were conducted. The results showed a body mass index decrease in both media and no significant change related to BMI (p = 0.733). However, the decrease was more shown on the leaflet, where the body fat percentage had a significant change (p = 0.000). Hence, intervention using the leaflet is more effective on nutritional status changes related with BMI and body fat percentage in obese students.

Online Affirmation and Peer Support are Effective for Reducing Medical Personnel Stress in Dealing with Covid-19 Patients

The Covid-19 outbreak has psychological impacts on frontline medical personnel at risk of infection. Therefore, this study aimed to evaluate the effect of online affirmations and peer support on medical personnel stress level in dealing with Covid-19 patients, as well as social support and spiritual intelligence's influence. It was a quasi-experiment with pre- and post-test administered to 25 and 30 medical personnel as the intervention and control groups, respectively. The intervention was carried out on WhatsApp group for 4 weeks. The stress level pair T-test results showed p = 0.000 in the intervention group and p = 0.238 in the control, while the independent T-test results showed p = 0.009. Social support did not affect medical personnel’s stress (p=0.978), but the effect of spiritual intelligence was significant (p=0.000). According to the results of multiple regression test conducted using the Enter method, the coefficient value (R2) = 0.584. This intervention was effective in helping medical personnel to manage stress. Hence, hospital managers need to carry out stress management training to maintain medical personnel’s mental health.

Knowledge of Tuberculosis among Tuberculosis Patients Attending Federal Medical Centre, Owo, Ondo State, Nigeria

Globally, tuberculosis (TB) constitutes a significant public health emergency. Despite the downward trend in TB incidence and prevalence, every continent still reports new cases, especially Africa and south-east Asia (WHO, 2012). This study aimed to investigate the signs, symptoms, transmission mode, and knowledge of tuberculosis (TB) among tuberculosis patients attending Federal Medical Centre, Owo, Ondo State Nigeria. A descriptive survey design was adopted, while sample population comprised of all the aforementioned tuberculosis patients. About 151 persons were selected using Multistage sampling procedure. A closed-ended questionnaire collection was used for data collection and the instrument was validated by experts with ascertained reliability. The data were then subjected to statistical analysis of Cronbach's alpha, and a correlation coefficient of 0.76 was obtained. Conclusively, the patients have knowledge of TB signs and symptoms as well as transmission mode. Therefore, this knowledge is recommended to be sustained among the patients. Multistage sampling procedure was used to select one hundred and fifty-one (151) a researcher’s designed closed-ended questionnaire was used for data collection. The instrument was validated by experts with reliability ascertained. The data obtained were subjected to statistical analysis of Cronbach alpha and a correlation coefficient of 0.76 was obtained. The findings reveals that: Tuberculosis patients have knowledge of signs and symptoms of TB, Tuberculosis patients have knowledge of mode of transmission of TB Therefore, the study concluded that tuberculosis patients have knowledge of mode of transmission, signs and symptoms of TB. Therefore, it is recommended that the knowledge of mode of transmission and symptoms of TB should be sustained among the patients.

Challenges and Support to HIV Care and Treatment of Female Sex Workers Living with HIV in Indonesia: A Mixed Method Study

This study aims to describe the experience of female sex workers (FSWs) living with HIV in Indonesia during the care and treatment cascade, including the challenges and support associated with them. It was initiated by a trained community study team from OPSI, a national network for FSW community in the country. A mixed-method design was used, consisting of a cross-sectional survey and qualitative interviews conducted in four large cities in May and June 2019. Quantitative data were collected from 80 FSWs living with HIV, while qualitative interviews were conducted for 9 FSWs previously involved in the survey. Most of the FSWs were diagnosed with HIV at facility-based HIV testing services. While most FSWs delayed initiating their treatment, majority eventually commenced it. Overall treatment retention was fairly good, but some were being inconsistent or even stopped. However, individuals that have access to viral load test was low, leading to a small number of those confirming their viral suppression status. Conclusively, interventions directed to strengthen individuals’ literacy in HIV treatment and stigma management is recommended, as well as identification of maximum potential support systems around the FSWs.

Factors Related to Utilization of Maternal Child Health Handbook Data by Midwives

Midwives are one of the health workers utilizing the MCH (Maternal Child Health) handbook which records the data used to prevent infant, under-five, and maternal mortality. This study aimed to investigate factors related to utilization of the MCH handbook data, namely individual, organizational, and operational techniques. Quantitative approach was used in a cross-sectional survey with a structured questionnaire. Thirty-one midwives were selected as the sample from Active Alert Village in Temanggung district with rural and urban area representative consideration. Besides, descriptive data were tabulated, and inferential analysis was conducted by Pearson product-moment correlation. Result showed the rate of MCH Handbook data utilization was 78.54%. Also, data requirement perception, data filling skill, motivation, attitudes of midwives and facilities availablity (p < 0.05) are significantly related. The MCH handbook data utilization was determined by the individual factor, but with no significant relationship to operational and organizational factors except facilities availability. Therefore, efforts are required to improve data utilization by increasing data requirement perception, data filling skills, motivation and midwives attitudes.

Patient Perceptions Toward the Changes in Outpatient Oncology Service During the COVID-19 Pandemic

COVID-19 crisis has posed an enormous challenge for all healthcare services. Therefore, this study aimed to describe the cancer patients’ knowledge and perceptions on oncology service quality during the COVID-19 pandemic. Cancer outpatient knowledge and perceptions toward the changes in chemotherapy and radiotherapy service in response to the pandemic was evaluated using a questionnaire. Majority of the 230 participants were knowledgeable about the pandemic and more than 95% of them claimed to sufficiently practice preventive measures. Television and the internet were their main source of information, and despite the fear of being infected by the COVID-19 virus, less than 15% of the respondents thought to stop or delay hospital visits. Generally, the changes in oncology service were well-received by the patients and they trust the health care workers in maintaining their safety. Also, oncology services delivery to outpatients remains consistent despite several alterations in hospital policies. Personal protective equipment utilization by health care workers and patients proved to be an important factor in reducing anxiety during hospital visits. Policy makers need to fully utilize the internet and associated mobile applications as an education tool.

Type D Personality and Essential Hypertension in Semarang City, Indonesia: A Primary Healthcare Center-based Case-Control Study

Type D personality is defined as the interaction between negative affectivity (NA) and social inhibition (SI). Hypertension has the highest cases in primary healthcare center (PHC) in Semarang City compared to other non-communicable diseases. This study aims to determine type D personality role on essential hypertension. It was a case-control study conducted at the PHC in Semarang City from January 2020 to March 2021 with 139 cases and 139 controls among 18-60 years old patients. Sample collection was performed by stratified random sampling. The instruments used were the DS-14 scale, structured questionnaire IPAQ-SF, food frequency questionnaire, and the Holmes and Rahe Stress Scale, while data were analyzed using logistic regression. The prevalence of type D personality in the case group (64%; 95%CI: 55.9%-72.1%) was higher than in the control (36.7%; 95%CI: 28.7%-44.7%). Type D personality was discovered to be significantly associated with essential hypertension (OR: 3.07; 95%CI: 1.83-5.16). After other covariates adjustment, the association was still statistically significant (AdjOR: 2.41; 95%CI: 1.32-4.41).

Does Health Insurance Affect the Completeness of Antenatal Care?

The antenatal treatment has been ineffective in reducing maternal mortality. Therefore, this study aimed to examine health insurance effect on Indonesia's antenatal care quality. The 2017 Indonesian Demographic and Health Survey data were processed. Moreover, a sample size of 15,351 participants was selected using the analysis unit of study for women aged 15 to 49. In the final stage, Binary Logistic Regression was used, while other variables examined besides antenatal treatment included health insurance, residence, age, marital, education, parity, and wealth. Based on the complete category of antenatal care visits, women that did antenatal care visits were ≥ four, occupied by both types of health insurance ownership. The multivariable analysis indicated that health insurance ownership affects antenatal care completeness as insured women were 1.394 times higher than uninsured women (OR= 1.394; 95% CI= 1.257-1.546). Result showed other determinant variables, namely age, education, parity, and wealth were also found. In conclusion, health insurance gives Indonesian women a better possibility of receiving complete antenatal care.

Health Policy Challenge for Breast Cancer Prevention: A Case Report

Breast cancer early diagnosis increases treatment chances, and self-examination is one of the commonest screening methods employed by women. The case of a 24-year-old Iranian woman with a history of mild mental retardation and chest pain was reported. A large lump was detected in the breast during visitation to the surgical clinic. The parents stated the lump was noticed due to a shape change in the clothes covering the patient's chest area. Therefore, the patient had mastectomy surgery after a biopsy and a malignant breast lump was confirmed. The registration and identification of people with mental disorder histories or various mental retardation degrees in each region's health centers to periodically assess their breast health tend to reduce the risk of late breast cancer detection in women.

Integrated Health Education (IHE) Method: An Impact on Tuberculosis Health Education for the Sub-district of Sumowono Society, Indonesia

Tuberculosis (TB) case results in Semarang Regency is still in the low category. The IHE method was developed through counseling and training to support the community empowerment needed in assisting TB cases handling and determination. This study aims to determine the IHE method's effect and effectiveness on the knowledge and attitudes of Pemberdayaan Kesejahteraan Keluarga (Empowerment of Family Welfare; PPK) members regarding TB disease. A quasi-experimental one-group pretest-postest design and a sample size of 25 active PKK members in the Sumowono sub-district were used. Then, the data were analyzed using the Wilcoxon test and N-Gran Score. The results showed the IHE method's effect on PKK members knowledge and attitudes regarding TB disease with P-values of 0.034 and 0.029, respectively. The IHE method effectively improved the PKK members attitudes towards TB disease (mean= 61.43%). There was an increase in the knowledge and attitudes of PKK mothers about TB disease through health education using the IHE method. The development in IHE is needed to be applied as a health education method in various other diseases.