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1.
J Environ Radioact ; 235-236: 106593, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34062380

RESUMEN

Radionuclides produced by 20th-century human nuclear activities from 1945 (e.g., atmospheric nuclear explosions and nuclear-fuel reprocessing) made significant impacts on earth's surface environments. Long-lived shallow-water corals living in tropical/subtropical seas incorporate the anthropogenically-produced radionuclides, including 129I and 14C, into their skeletons, and provide time series records of the impacts of nuclear activities. Here, we present 129I/127I and Δ14C time series records of an annually-banded modern coral skeleton from Rowley Shoals, off the northwestern coast of Australia, in the far eastern Indian Ocean. The 129I/127I and Δ14C records, covering the period 1930s-1990s, exhibit distinct increases caused by the nuclear activities, and their increasing profiles are clearly different from each other. The first distinct 129I/127I increase occurs from 1955 to 1959, followed by a decrease in 1960-1963. The increase is probably due to US atmospheric nuclear explosions in Bikini and Eniwetok Atolls in 1954, 1956 and 1958. The 129I produced in those nuclear tests would be transported by the North Equatorial Current, a portion of which passes through the Indonesian Throughflow and then reaches Rowley Shoals. This initial increase from 1955 is, however, absent in the Δ14C record, which shows a distinct increase from 1959 and its peak around the mid-1970s, followed by a gradual decrease. This absence and the 4-year-delayed Δ14C increase are likely due to dilution of explosion-produced 14C with natural carbon (by seawater mixing and air-sea gas exchange) being much more intense than that of explosion-produced 129I with natural iodine (by the same processes), suggesting that the 129I/127I ratio is a more conservative anthropogenic tracer in surface ocean waters, as compared to Δ14C. The second 129I/127I increase is contemporaneous with a rapid Δ14C increase during 1964-1967, followed by a rapid 129I/127I decrease in 1968-1969; the increases can be ascribed to very large atmospheric nuclear explosions conducted in the former Soviet Union in 1961-1962. The third 129I/127I increase appears between 1969/1970 and 1992, which can be attributed to airborne 129I released from nuclear-fuel reprocessing facilities in Europe, the former Soviet Union and the US. The coral 129I/127I and Δ14C time series records, combined with previous studies, enhance our understanding of the behavior of anthropogenic 129I and 14C in the global ocean and atmosphere.


Asunto(s)
Antozoos , Monitoreo de Radiación , Animales , Atmósfera , Australia , Europa (Continente) , Humanos , Océano Índico , Indonesia , Radioisótopos de Yodo , Agua de Mar , U.R.S.S.
2.
BMC Public Health ; 21(1): 1024, 2021 05 31.
Artículo en Inglés | MEDLINE | ID: mdl-34059029

RESUMEN

BACKGROUND: Limited information is available on how mobile health (mHealth) application (app) technology on mother and child health (MCH) is developed. This research aimed (a) to explore the process of developing mobile apps for MCH community-based services in the Indonesian setting of Pos Pelayanan Terpadu (Posyandu/Integrated Health Service Post), (b) to determine the feasibility of using the app by community health workers (CHWs), and (c) to evaluate the scalability of the mobile app at the national level in Indonesia. METHODS: A hybrid method was used to synergistically combine the action research principles and mixed methods comprising qualitative and quantitative methods. This study was conducted in the Pasawahan District, Purwakarta, Indonesia, from 2017 to 2019. Content analysis, coding, and categorizing were performed using NVivo 12 Pro for transcribed data. The Wilcoxon test (2018 and 2019) was conducted using STATA 15 Special Edition. RESULTS: (1) The use of a CHW notebook for data entry into the Posyandu Information System book delayed the data reporting process, resulting in the need to develop a mobile app. (2) There were significant differences in CHWs' knowledge (p = 0.000) and skills (p = 0.0097) on training (2018) and Posyandu phases (2019). (3) A total of 964 Posyandu have been registered in the Posyandu mobile app from almost all provinces in Indonesia. CONCLUSIONS: The three-year hybrid approach includes the crucial phases that are necessary to develop a mobile app that is more user-friendly and can act as a substitute for CHWs' book. Hence, its implementation is promising for use at the national level.


Asunto(s)
Aplicaciones Móviles , Telemedicina , Niño , Servicios de Salud Comunitaria , Agentes Comunitarios de Salud , Humanos , Indonesia
3.
Artículo en Inglés | MEDLINE | ID: mdl-34064580

RESUMEN

(1) Background: because of close contacts with COVID-19 patients, hospital workers are among the highest risk groups for infection. This study examined the socioeconomic and behavioral correlates of COVID-19 infection among hospital workers in Indonesia, the country hardest-hit by the disease in the Southeast Asia region. (2) Methods: we conducted a cross-sectional study, which collected data from 1397 hospital staff from eight hospitals in the Greater Jakarta area during April-July 2020. The data was collected using an online self-administered questionnaire and Reverse Transcription-Polymerase Chain Reaction (RT-PCR) tests. We employed descriptive statistics and adjusted and unadjusted logistic regressions to analyze the data of hospital workers as well as the subgroups of healthcare and non-healthcare workers. (3) Results: from a total of 1397 hospital staff in the study, 22 (1.6%) were infected. In terms of correlates, being a healthcare worker (adjusted odds ratio (AOR) = 8.31, 95% CI 1.27-54.54) and having a household size of more than five (AOR = 4.09, 1.02-16.43) were significantly associated with a higher risk of infection. On the other hand, those with middle- and upper-expenditure levels were shown to have a lower risk of infection (AOR = 0.06, 0.01-0.66). Behavioral factors associated with COVID-19 infection among healthcare and non-healthcare workers included knowledge of standard personal protective equipment (PPE) (AOR = 0.08, 0.01-0.54) and application of the six-step handwashing technique (AOR = 0.32, 0.12-0.83). (4) Conclusion: among hospital staff, correlates of COVID-19 infection included being a healthcare worker, household size, expenditure level, knowledge and use of PPE, and application of appropriate hand washing techniques.


Asunto(s)
Estudios Transversales , Personal de Salud , Hospitales , Humanos , Indonesia/epidemiología , Personal de Hospital , Factores Socioeconómicos
4.
BMC Public Health ; 21(1): 1037, 2021 06 02.
Artículo en Inglés | MEDLINE | ID: mdl-34078329

RESUMEN

BACKGROUND: To assess if physical distancing measures to control the COVID-19 pandemic can be relaxed, one of the key indicators used is the reproduction number R. Many developing countries, however, have limited capacities to estimate R accurately. This study aims to demonstrate how health production function can be used to assess the state of COVID-19 transmission and to determine a risk-based relaxation policy. METHODS: The author employs a simple "bridge" between epidemiological models and production economics to establish the cumulative number of COVID-19 cases as a short-run total product function and to derive the corresponding marginal product, average product, and production elasticity. Three crucial dates defining the states of transmission, labelled red, yellow, and green zones, are determined. Relaxation policy is illogical in the "red zone" and is not recommended in the "yellow zone". In the "green zone", relaxation can be considered. The Bayesian probability of near term's daily cases meeting a policy target is computed. The method is applied to France, Germany, Italy, the UK, and the US, and to Indonesia as an example of application in developing countries. RESULTS: This study uses data from the WHO COVID-19 Dashboard, beginning from the first recording date for each country until February 28, 2021. As of June 30, 2020, France, Germany, Italy, and the UK had arrived at the "green zone" but with a high risk of transmission re-escalations. In the following weeks, their production elasticities were rising, giving a signal of accelerated transmissions. The signal was corroborated by these countries' rising cases, making them leaving the "green zone" in the later months. By February 28, 2021, the UK had returned to the "green zone", France, Germany, and Italy were still in the "yellow zone", while the US reached the "green zone" at a very high number of cases. Despite being in the "red zone", Indonesia relaxed its distancing measures, causing a sharp rise of cases. CONCLUSIONS: Health production function can show the state of COVID-19 transmission. A rising production elasticity gives an early warning of transmission escalations. The elasticity is a useful parameter for risk-based relaxation policy.


Asunto(s)
Pandemias , Teorema de Bayes , Francia , Alemania , Política de Salud , Humanos , Indonesia , Italia , Políticas
5.
J Environ Manage ; 292: 112804, 2021 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-34023789

RESUMEN

17α-ethynylestradiol (EE2) is a synthetic estrogen with very strong estrogenic potency. Due to its wide usage in human and livestock as well as its high recalcitration to biodegradation, it was ubiquitous in different environment. This review summarized EE2 concentration levels in surface waters among 32 countries across seven continents. EE2 concentrations varied greatly in different surface waters, which ranged from not detected to 17,112 ng/L. The top 10 countries ranked in the order of high to low average EE2 concentration in surface water, were Vietnam, Cambodia, China, Laos, Brazil, Argentina, Kuwait, Thailand, Indonesia and Portugal, with the respective mean concentrations of 27.7, 22.1, 21.5, 21.1, 13.6, 9.6, 9.5, 8.8, 7.6 and 6.6 ng/L. Generally speaking, the EE2 concentration levels in surface waters in developing countries were much higher than those in developed countries. EE2 in effluent of municipal wastewater treatment plant (WWTP) was the dominant source to most countries, which suggested that improving the EE2 removal performance of municipal WWTP is the key to mitigate EE2 contamination to surface water body. Livestock, hospital, pharmacy factory and aquaculture wastewaters were also the important sources, but further work should be performed to elucidate their contribution. Evaluation based on estrogenic effects, the EE2-derived estrogen equivalence in surface waters ranged from 0 to 33 ng E2/L, among which about 65% of surface waters among 32 countries were at risk or high risk, indicating global serious EE2 contamination. MAIN FINDING: EE2 concentration in surface waters across 32 countries were summarized, along which its potential estrogenic effects were evaluated.


Asunto(s)
Estrógenos , Contaminantes Químicos del Agua , Argentina , Brasil , Cambodia , China , Estrógenos/análisis , Etinilestradiol/análisis , Humanos , Indonesia , Portugal , Tailandia , Vietnam , Eliminación de Residuos Líquidos , Agua , Contaminantes Químicos del Agua/análisis
6.
Artículo en Inglés | MEDLINE | ID: mdl-33971088

RESUMEN

PURPOSE: Distance learning, which became widespread in response to the coronavirus disease 2019 (COVID-19) pandemic, has been a burdensome challenge for students and lecturers. This study investigated the relationship between academic self-efficacy and burnout in first-year nursing students who participated in distance learning during the COVID-19 pandemic. METHODS: The study included 69 first-year nursing students at Jenderal Achmad Yani University in Yogyakarta, Indonesia. Data were collected in September 2020 through self-efficacy and burnout questionnaires that were distributed via email and social media for 2 weeks. The responses were analyzed using the gamma test. RESULTS: Most respondents were women (78.3%), with an average age of 19 years. Most nursing students had a moderate level of academic self-efficacy (72.5%), while only 13.0% of respondents had a low level of academic self-efficacy. However, 46.4% of students experienced severe burnout during distance learning. Cross-tabulation showed that students with moderate self-efficacy were more likely to experience severe burnout (24 respondents) (P<0.01 and r=-0.884). Exhaustion was the burnout dimension most closely associated with academic self-efficacy. CONCLUSION: Students perceived distance learning as burdensome and reported high levels of exhaustion, which may negatively impact their academic achievement. Interventions to improve academic self-efficacy may foster students' confidence, potentially leading to reduced burnout levels. Nurse educators should reflect upon innovative learning strategies to create a favorable learning environment for nursing students.


Asunto(s)
Rendimiento Académico/psicología , Agotamiento Psicológico/psicología , Educación a Distancia , Autoeficacia , Estudiantes de Enfermería/psicología , Femenino , Humanos , Indonesia , Masculino , Adulto Joven
7.
BMJ Open ; 11(5): e045592, 2021 05 21.
Artículo en Inglés | MEDLINE | ID: mdl-34020977

RESUMEN

INTRODUCTION: Caesarean section (C-section) has been a public health concern globally. This study investigated the change in C-section rate in 1998-2017 in Indonesia and explored the socioeconomic, geographic and health system factors associated with the use of C-section. METHODS: We analysed data from demographic health surveys in 2002-2003, 2007, 2012 and 2017 in Indonesia. We included women who reported giving birth within 5 years of each round of the survey (n=56 462) into the analysis. Cross-tabulation was used to examine change of C-section rate by year. We conducted bivariate and multivariate logistic regressions to study the determinants of C-section use. RESULTS: In Indonesia, the C-section rate increased from 4.0% in 1998 to 18.5% in 2017. In 2017, the C-section rate in urban areas (22.9%) was almost two times that in rural areas (11.8%). It was almost three times among the richest wealth quintile (36.5%), compared with the poorest wealth quintile (12.9%). Between 2008 and 2017, the difference in the C-section rate by public services enlarged between the poorest and the richest groups. The absolute increase of the C-sections by private services was more than public services over time. In 2013-2017, the C-section rates by public and private services were 22.5% and 23.1%, respectively. After adjusting for all variables, higher education, higher household wealth, primiparity and use of public childbirth services were positively associated with C-section. CONCLUSIONS: The C-section rate increased steadily in the past two decades in Indonesia. Women's socioeconomic status and health system factors were associated with the increased use of C-section.


Asunto(s)
Cesárea , Población Rural , Estudios Transversales , Demografía , Femenino , Encuestas Epidemiológicas , Humanos , Indonesia/epidemiología , Embarazo , Factores Socioeconómicos
8.
PLoS One ; 16(5): e0251234, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33956869

RESUMEN

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to a global pandemic, including Indonesia. However, there are only limited data regarding the precise prevalence of the COVID-19 pandemic in Indonesia. Here, to estimate the magnitude of SARS-CoV-2 infection in East Java, Indonesia, we investigated the prevalence of immunoglobulin G (IgG) antibodies. We enrolled 1,819 individuals from June to December 2020 and observed that the subjects' overall prevalence of IgG antibody to SARS-CoV-2 was 11.4% (207/1,819). The prevalence of anti-SARS-CoV-2 antibodies differed significantly between the job/occupation groups (P = 0.0001). A greater prevalence of IgG was detected in laboratory technicians (who take samples from suspected cases and deal with polymerase chain reaction [PCR] procedures, 22.2%) compared to medical personnel who see and take direct care of patients with COVID-19 (e.g., physicians and nurses, 6.0%), other staff in medical facilities (2.9%), general population (12.1%) and non-COVID-19 patients (14.6%). The highest prevalence among age groups was in the 40-49-year-olds (14.8%), and the lowest prevalence was in the 20-29-year-olds (7.4%). However, the younger population still showed a higher prevalence than generally reported, suggesting greater exposure to the virus but less susceptibility to the disease. A geographical difference was also observed: a higher prevalence in Surabaya (13.1%) than in Jombang (9.9%). In conclusion, the COVID-19 outbreak among asymptomatic populations was characterized by a high prevalence of infection in East Java, Indonesia.


Asunto(s)
/epidemiología , Adolescente , Adulto , Anticuerpos Antivirales/sangre , /diagnóstico , Femenino , Humanos , Inmunoglobulina G/sangre , Indonesia/epidemiología , Masculino , Persona de Mediana Edad , Estudios Seroepidemiológicos , Adulto Joven
9.
Front Public Health ; 9: 646764, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33996723

RESUMEN

Introduction: Before the widespread availability of an effective COVID-19 vaccine, it is crucial to control the rate of transmission by ensuring adherence to behavioral modifications, such as wearing masks, physical distancing, and washing hands, all of which can be implemented as public health measures. Focusing on the conditions in Bali, this study explored the level of compliance to public health measures targeted at COVID-19 and identified the determinants of compliance via the values, rules, and knowledge approach. Materials and Methods: This cross-sectional study conducted an online survey using the Google Form application from June 29 to July 5, 2020. The minimum required sample size was 664. Inclusion criteria were set as follows: 18 years of age or older and residing in Bali during the data collection period. Adherence was measured based on nine protocol indicators that were rated using a four-point Likert scale. A multiple linear regression analysis was then conducted to determine the associated factors of adherence to public health measures. Results: Of the 954 survey respondents, data from 743 were included for analysis. The average level of adherence to public health measures was 32.59 (range of 20-36). The linear regression analysis showed that perceived health benefits from public health measures, being female, and having COVID-19 test histories were significantly associated with adherence to public health measures. Conclusions: For public health measures targeted at COVID-19, adherence was strongly associated with perceived social norms, in which individuals played social community roles by adapting to standardized public health measures. It is thus imperative for governments to support and monitor public health measures during the COVID-19 pandemic.


Asunto(s)
Pandemias , Adolescente , Adulto , Estudios Transversales , Femenino , Humanos , Indonesia , Salud Pública , Normas Sociales
10.
Hum Genomics ; 15(1): 29, 2021 05 17.
Artículo en Inglés | MEDLINE | ID: mdl-34001248

RESUMEN

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a global health problem that causes millions of deaths worldwide. The clinical manifestation of COVID-19 widely varies from asymptomatic infection to severe pneumonia and systemic inflammatory disease. It is thought that host genetic variability may affect the host's response to the virus infection and thus cause severity of the disease. The SARS-CoV-2 virus requires interaction with its receptor complex in the host cells before infection. The transmembrane protease serine 2 (TMPRSS2) has been identified as one of the key molecules involved in SARS-CoV-2 virus receptor binding and cell invasion. Therefore, in this study, we investigated the correlation between a genetic variant within the human TMPRSS2 gene and COVID-19 severity and viral load. RESULTS: We genotyped 95 patients with COVID-19 hospitalised in Dr Soetomo General Hospital and Indrapura Field Hospital (Surabaya, Indonesia) for the TMPRSS2 p.Val160Met polymorphism. Polymorphism was detected using a TaqMan assay. We then analysed the association between the presence of the genetic variant and disease severity and viral load. We did not observe any correlation between the presence of TMPRSS2 genetic variant and the severity of the disease. However, we identified a significant association between the p.Val160Met polymorphism and the SARS-CoV-2 viral load, as estimated by the Ct value of the diagnostic nucleic acid amplification test. Furthermore, we observed a trend of association between the presence of the C allele and the mortality rate in patients with severe COVID-19. CONCLUSION: Our data indicate a possible association between TMPRSS2 p.Val160Met polymorphism and SARS-CoV-2 infectivity and the outcome of COVID-19.


Asunto(s)
/genética , Predisposición Genética a la Enfermedad/genética , Polimorfismo de Nucleótido Simple , Serina Endopeptidasas/genética , Adulto , Alelos , /virología , Estudios Transversales , Femenino , Frecuencia de los Genes , Genotipo , Humanos , Indonesia , Masculino , Persona de Mediana Edad , Carga Viral/genética
11.
BMC Res Notes ; 14(1): 206, 2021 May 28.
Artículo en Inglés | MEDLINE | ID: mdl-34049578

RESUMEN

OBJECTIVE: Biomarker mRNA levels have been suggested to be predictors of patient survival and therapy response in melanoma cases. This study aimed to investigate the correlations between the mRNA expression levels of PD-L1 and NKG2A in melanoma tissue with clinicopathologic characteristics and survival in Indonesian primary nodular melanoma patients. RESULTS: Thirty-one tissue samples were obtained; two were excluded from survival analysis due to Breslow depth of less than 4 mm. The median survival of upregulated and normoregulated PD-L1-patients were 15.800 ± 2.345 and 28.945 ± 4.126 months, respectively. However, this difference was not significant statistically (p = 0.086). Upregulated and normoregulated NKG2A patients differed very little in median survival time (25.943 ± 7.415 vs 26.470 ± 3.854 months; p = 0.981). Expression of PD-L1 and NKG2A were strongly correlated (rs: 0.787, p < 0.001). No clinicopathologic associations with PD-L1 and NKG2A mRNA levels were observed. These results suggest that PD-L1 may have potential as a prognostic factor. Although an unlikely prognostic factor, NKG2A may become an adjunct target for therapy. The strong correlation between PD-L1 and NKG2A suggests that anti-PD-1 and anti-NKG2A agents could be effective in patients with PD-L1 upregulation. The mRNA levels of these two genes may help direct choice of immunotherapy and predict patient outcomes.


Asunto(s)
Melanoma , Neoplasias Cutáneas , Antígeno B7-H1/genética , Humanos , Indonesia , Melanoma/genética , Subfamília C de Receptores Similares a Lectina de Células NK , Pronóstico , Neoplasias Cutáneas/genética
12.
Front Public Health ; 9: 621800, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34055709

RESUMEN

Hand hygiene practices are important not only during the corona virus disease 2019 (COVID-19) pandemic, but also critical to prevent the possible spread of other infectious diseases. This study aims to examine the current hand hygiene behaviors during the COVID-19 pandemic, post pandemic behavior intentions, and the relationship between behavior, psychosocial and contextual factors. A cross-sectional online survey was conducted from 28 May to 12 June 2020, with 896 valid responses obtained from Indonesian citizens over 18 years old. The survey questions included demographic characteristics, individual practices, risk perceptions, attitude, norm factors and ability factors related to hand hygiene during the COVID-19 pandemic. Descriptive analysis, chi square and multiple logistic regression tests were used to analyse the data. The results showed that 82.32% of female respondents and 73.37% male respondents reported handwashing practice 8 times or more per day during COVID-19 pandemic. Participants who perceived themselves at higher risk of contracting SARS-CoV-2 (OR 7.08, 2.26-22.17), had less negative perception toward the practice (OR 1.93, 1.32-2.82), perceived handwashing as an effective preventive measure (OR 1.77, 1.23-2.54), were female (OR 1.71, 1.21-2.41), perceived a more supportive norm (OR 1.68, 1.15-2.44) and noticed more barriers in access to handwashing facilities (OR 1.57, 1.05-2.36) were more likely to engage in hand hygiene practice more frequently during the pandemic. In conclusion, the majority of respondents did increase their frequency of hand hygiene practices during COVID-19 pandemic. In line with previous studies in other pandemic contexts, sex, perceived susceptibility and effectiveness are important predictors of hand hygiene practices, which are similar to findings from previous studies in other pandemic contexts. Addressing social norm related to the perceived hand hygiene practices of friends and important people is a potential health promotion strategy by creating hand hygiene norms in the community.


Asunto(s)
Higiene de las Manos , Adolescente , Estudios Transversales , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Indonesia/epidemiología , Masculino , Pandemias/prevención & control , Opinión Pública
13.
J Med Case Rep ; 15(1): 259, 2021 May 03.
Artículo en Inglés | MEDLINE | ID: mdl-33941249

RESUMEN

BACKGROUND: Coronavirus disease 2019 (COVID-19) was first identified in Indonesia in March 2020, and the number of infections has grown exponentially. The situation is at its worst, overwhelming intensive care unit (ICU) resources and capacity. CASE PRESENTATION: This is a single-center observational case study of 21 confirmed COVID-19 patients admitted to the ICU from March 20, 2020, to April 31, 2020. Demographics, baseline comorbidities, clinical symptoms, laboratory tests, electrocardiogram (ECG) and chest imaging were obtained consecutively during patient care. We identified 21 patients with confirmed COVID-19 severe infection in our ICU. The mean (± standard deviation) age of the patients was 54 ± 10 years; 95% were men, with shortness of breath (90.6%) the most common symptom. Hypertension was identified as a comorbidity in 28.6% of patients. The most common reason for admission to the ICU was hypoxemic respiratory failure, with 80% (17 patients) requiring mechanical ventilation. Half of the patients (10) died between day 1 and day 18, with septic shock as the primary cause of death. Of the 11 surviving patients, five were discharged home, while six were discharged from the ICU but remained in the hospital ward. Even then, the median length of ICU stay amongst survivors was 18 days. CONCLUSIONS: To date, there are no known effective antiviral agents or specific therapy to treat COVID-19. As severe systemic inflammatory response and multiple organ failure seems to be the primary cause of death, supportive care in maintaining oxygenation and hemodynamic stability remain the mainstay goals in treating critically ill COVID-19 patients.


Asunto(s)
Unidades de Cuidados Intensivos , Índice de Severidad de la Enfermedad , Adulto , Anciano , /terapia , Femenino , Humanos , Indonesia , Masculino , Persona de Mediana Edad
14.
BMC Res Notes ; 14(1): 177, 2021 May 10.
Artículo en Inglés | MEDLINE | ID: mdl-33971946

RESUMEN

OBJECTIVE: To compare the live birth rates (LBR) and neonatal outcomes of frozen cycle in vitro fertilization (IVF) with fresh cycle IVF in the Indonesian population. RESULTS: This was retrospective study using secondary data of IVF patients at a private fertility centre. Study recruitment was between 3/8/2018 and 31/12/2019. Total sampling included all patients undergoing oocyte retrieval and embryo transfer within recruitment period. Patients undergoing fresh IVF cycles and frozen IVF cycles were compared. 351 patients were recruited: 68.1% (239/351) underwent fresh cycles and 31.9% (112/351) frozen cycles. AMH was significantly higher in frozen cycle group (p = 0.04). Ovulatory disorder was significantly higher in frozen cycle group (p = 0.001). Among patients aged ≤ 30, fresh cycle group had significantly higher LBR (p = 0.02). Among those with ovulatory disorder, LBR was significantly higher with frozen cycle. No significant LBR difference was noted with other infertility causes. When stratified according to pregnancy order, frozen cycle patients had significantly higher birth lengths (p = 0.03) but not length of gestation nor neonatal birthweights. There was no significant difference in the proportion of biochemical pregnancy resulting in LBR (p = 0.08). To conclude, frozen cycle provided higher LBR among patients with ovulatory disorder but fresh cycle was beneficial among patients aged ≤ 30.


Asunto(s)
Transferencia de Embrión , Fertilización In Vitro , Anciano , Tasa de Natalidad , Femenino , Humanos , Indonesia/epidemiología , Recién Nacido , Nacimiento Vivo , Embarazo , Estudios Retrospectivos
15.
Physiol Rep ; 9(10): e14876, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-34042296

RESUMEN

Inflammation plays a substantial role in COVID-19 pathophysiology. Ferritin and neutrophil-lymphocyte ratio (NLR) are significant prognostic biomarkers used in COVID-19 patients, although they are affected by other factors such as comorbidities and age. Aging changes the immune system through immunosenescence and inflammaging; however, there are limited number of studies evaluating its effect on ferritin and NLR as part of the complete assessment for intensive care requirement and mortality risk. A single-center retrospective cohort study of 295 COVID-19 patients was performed at the Siloam Hospitals Makassar, South Sulawesi, Indonesia from April to August 2020. After admission, all patients were followed up for clinical outcomes. Patients were grouped into strata based on age (<50 years vs. ≥50 years) and risk groups (low-risk ferritin vs. high-risk ferritin; low-risk NLR vs. high-risk NLR). The endpoints of the study were the intensive care requirements and mortality. Among the 295 COVID-19 patients, 264 survived and 31 deceased. Ferritin and NLR had higher area under curve (AUC) values than other inflammatory parameters and had significantly different outcomes in both mortality and intensive care requirement groups. The combination of ferritin and NLR showed higher AUC values for intensive care requirement and mortality (AUC, 0.783; 95% confidence interval, 0.703-0.864). Multivariate analysis showed that both endpoints were strongly affected by age, ferritin level, and NLR. Age significantly multiplied clinical endpoints in low-risk group patients but not in high-risk group patients. The combination of ferritin and NLR had a better predictive value for intensive care requirement and mortality risk. However, age strongly affects clinical outcome in low-risk groups of both ferritin and NLR groups; hence, it should be considered as an early predictive factor of COVID-19 disease progression.


Asunto(s)
/sangre , Ferritinas/sangre , Linfocitos , Neutrófilos , Adulto , Factores de Edad , Anciano , Biomarcadores/sangre , /mortalidad , Cuidados Críticos , Femenino , Mortalidad Hospitalaria , Humanos , Indonesia , Recuento de Linfocitos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Pronóstico , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Factores de Tiempo
16.
BMC Bioinformatics ; 22(1): 226, 2021 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-33932974

RESUMEN

BACKGROUND: Principal component analysis (PCA) is commonly applied to the atomic trajectories of biopolymers to extract essential dynamics that describe biologically relevant motions. Although application of PCA is straightforward, specialized software to facilitate workflows and analysis of molecular dynamics simulation data to fully harness the power of PCA is lacking. The Java Essential Dynamics inspector (JEDi) software is a major upgrade from the previous JED software. RESULTS: Employing multi-threading, JEDi features a user-friendly interface to control rapid workflows for interrogating conformational motions of biopolymers at various spatial resolutions and within subregions, including multiple chain proteins. JEDi has options for Cartesian-based coordinates (cPCA) and internal distance pair coordinates (dpPCA) to construct covariance (Q), correlation (R), and partial correlation (P) matrices. Shrinkage and outlier thresholding are implemented for the accurate estimation of covariance. The effect of rare events is quantified using outlier and inlier filters. Applying sparsity thresholds in statistical models identifies latent correlated motions. Within a hierarchical approach, small-scale atomic motion is first calculated with a separate local cPCA calculation per residue to obtain eigenresidues. Then PCA on the eigenresidues yields rapid and accurate description of large-scale motions. Local cPCA on all residue pairs creates a map of all residue-residue dynamical couplings. Additionally, kernel PCA is implemented. JEDi output gives high quality PNG images by default, with options for text files that include aligned coordinates, several metrics that quantify mobility, PCA modes with their eigenvalues, and displacement vector projections onto the top principal modes. JEDi provides PyMol scripts together with PDB files to visualize individual cPCA modes and the essential dynamics occurring within user-selected time scales. Subspace comparisons performed on the most relevant eigenvectors using several statistical metrics quantify similarity/overlap of high dimensional vector spaces. Free energy landscapes are available for both cPCA and dpPCA. CONCLUSION: JEDi is a convenient toolkit that applies best practices in multivariate statistics for comparative studies on the essential dynamics of similar biopolymers. JEDi helps identify functional mechanisms through many integrated tools and visual aids for inspecting and quantifying similarity/differences in mobility and dynamic correlations.


Asunto(s)
Proteínas , Programas Informáticos , Indonesia , Simulación de Dinámica Molecular , Análisis de Componente Principal , Conformación Proteica
17.
BMC Health Serv Res ; 21(1): 427, 2021 May 05.
Artículo en Inglés | MEDLINE | ID: mdl-33952273

RESUMEN

BACKGROUND: Multimorbidity (the presence of two or more non-communicable diseases) is a major growing challenge for many low-income and middle-income countries (LMICs). Yet, its effects on health care costs and financial burden for patients have not been adequately studied. This study investigates the effect of multimorbidity across the different percentiles of healthcare utilisation and out-of-pocket expenditure (OOPE). METHODS: We conducted a secondary data analysis of the 2014/2015 Indonesian Family Life Survey (IFLS-5), which included 13,798 respondents aged ≥40 years. Poisson regression was used to assess the association between sociodemographic characteristics and the total number of non-communicable diseases (NCDs), while multivariate logistic regression and quantile regression analysis was used to estimate the associations between multimorbidity, health service use and OOPE. RESULTS: Overall, 20.8% of total participants had two or more NCDs in 2014/2015. The number of NCDs was associated with higher healthcare utilisation (coefficient 0.11, 95% CI 0.07-0.14 for outpatient care and coefficient 0.09 (95% CI 0.02-0.16 for inpatient care) and higher four-weekly OOPE (coefficient 27.0, 95% CI 11.4-42.7). The quantile regression results indicated that the marginal effect of having three or more NCDs on the absolute amount of four-weekly OOPE was smaller for the lower percentiles (at the 25th percentile, coefficient 1.0, 95% CI 0.5-1.5) but more pronounced for the higher percentile of out-of-pocket spending distribution (at the 90th percentile, coefficient 31.0, 95% CI 15.9-46.2). CONCLUSION: Multimorbidity is positively correlated with health service utilisation and OOPE and has a significant effect, especially among those in the upper tail of the utilisation/costs distribution. Health financing strategies are urgently required to meet the needs of patients with multimorbidity, particularly for vulnerable groups that have a higher level of health care utilisation.


Asunto(s)
Gastos en Salud , Enfermedades no Transmisibles , Anciano , Estudios Transversales , Humanos , Indonesia/epidemiología , Multimorbilidad , Análisis de Regresión
18.
Front Public Health ; 9: 612994, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34041213

RESUMEN

Objectives: Indonesia responded the COVID-19 pandemic slowly these last months. The recent reports shown that the rate performance of Indonesian government in handling COVID-19 posits at the 4th worst all over the world. Meanwhile, through responsive, strict, and strategic policy, some Asia countries pushed the elimination case by doing lockdown. This paper questioned how government respond this pandemic, tried to track down the unresponsive and slow decisions, and analyze them comprehensively trough policy system framework. Moreover, we also considered a few feasible and strategic recommendations to accelerate the pandemic responding. Methods: To visualize the anatomy of problems in handling these pandemic responses, this work applied Easton's black box analysis in formulating and introducing public policy. The black box analysis would help us to portray and understood the interests, rationalities, and priorities behind introducing public policies which was implemented to handle this health problem. Besides, the policy triangle framework was used to analyze how environment influenced key actor in making decision. Results: This analysis study discovered the conflict interests in formulating and implementing public policy in handling COVID-19. The public policies are negotiated, discussed, and formulated under black box that ignore transparency, and other good governance principles. Consequently, the substance of public policy represents a certain interest of policy makers, that may conflict with the others and often contradict to the constitutional-based public interests, that is public health. It was impacted the emergence of messy and uncoordinated institutions that implement the conflicted policies. Undeniably, this situation may spark counter-productive ways, attitudes, and actions of people in responding those ambiguous policies. Therefore, this work recommended revising the coherences norms and public policies; reforming the ministry of health in public health's paradigm context; and improving the integration and coordination of cross related institutions, creating a single data on public health, and changing a new paradigm of people, including improving collective awareness in responding and handling COVID-19 appropriately.


Asunto(s)
Pandemias , Asia , Control de Enfermedades Transmisibles , Gobierno , Humanos , Indonesia/epidemiología , Pandemias/prevención & control , Política Pública
19.
Artículo en Inglés | MEDLINE | ID: mdl-34011623

RESUMEN

OBJECTIVE: This study will test the performance of the anal swab PCR test when compared with the nasopharyngeal swab PCR test as a diagnostic tool for COVID-19. DESIGN: An observational descriptive study which included hospitalised suspected, or probable cases of hopitalised COVID-19 patients, conducted in Dr. Cipto Mangunkusumo National Hospital, Ciputra Hospital, Mitra Keluarga Depok Hospital and Mitra Keluarga Kelapa Gading Hospital, Indonesia. Epidemiological, clinical, laboratory and radiology data were obtained. Nasopharyngeal and anal swabs specimens were collected for SARS-CoV-2 RNA detection. RESULTS: We analysed 136 subjects as part of this study. The clinical spectrum of COVID-19 manifesation in this study was typical of hospitalised patients, with 25% classified as mild cases, 14.7% in severe condition and 12.5% of subjects classified as having acute respiratory distress syndrome. When compared with nasopharyngeal swab as the standard specimen for reverse transcription polymerase chain reaction (RT-PCR) detection of SARS-CoV-2 antigen, the sensitivity and specificity of the anal swab was 36.7% and 93.8%, respectively. The positive and negative predictive value were 97.8% and 16.5 %, respectively. The performance of the anal swab remained similar when only the subgroup of patients with gastrointestinal symptoms (n=92, 67.6%) was analysed (sensitivity 40% and specificity 91.7%). Out of all the subjects included in analysis, 67.6% had gastrointestinal symptoms. Similarly, 73.3% of patients in the anal swab-positive group had gastrointestinal symptoms. The two most common gastrointestinal symptoms in the subjects' population were nausea and anorexia. CONCLUSION: Anal swab specimen has low sensitivity (36.7%) but high specificity (93.8%) for detecting SARS-CoV-2 antigen by RT-PCR. Only one additional positive result was found by anal swab among the nasopharyngeal swab-negative group. Anal swab may not be needed as an additional test at the beginning of a patient's diagnostic investigation and nasopharyngeal swab RT-PCR remains as the standard diagnostic test for COVID-19.


Asunto(s)
Canal Anal/virología , Enfermedades Gastrointestinales/virología , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/métodos , /genética , Adulto , /virología , Pruebas Diagnósticas de Rutina/normas , Pruebas Diagnósticas de Rutina/estadística & datos numéricos , Femenino , Enfermedades Gastrointestinales/diagnóstico , Hospitalización , Humanos , Indonesia/epidemiología , Masculino , Persona de Mediana Edad , Nasofaringe/virología , Valor Predictivo de las Pruebas , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/estadística & datos numéricos , Sensibilidad y Especificidad
20.
Front Public Health ; 9: 630295, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34026709

RESUMEN

Introduction: Repatriated Indonesian migrant workers are vulnerable to developing serious mental health problems during the COVID-19 pandemic. This study aimed to assess the prevalence and associated factors of depression, anxiety, and stress among these populations during the COVID-19 pandemic. Methods: Guided by the health belief model, a cross-sectional study design was employed among 335 participants, and primary data were collected through an online survey. Measured using DASS-21, anxiety, depression, and stress were the dependent variables. We performed descriptive and inferential statistical analyses-logistic regression was used to predict independently associated variables. STATA was used to execute all data analyses. Results: The prevalence of depression, anxiety, and stress among repatriated Indonesian migrant workers were 10.15, 9.25, and 2.39%, respectively. The risk of anxiety and depression was low among those aged 21-30 years old, who had completed a university degree, were married, and had quarantined for 14 days. Conversely, the risk of anxiety and depression was high among those who had bad perceived health status, high perceived susceptibility, and negative stigma perception. Conclusion: The prevalence of depression, anxiety, and stress among repatriated Indonesian migrant workers was relatively low compared to the general population. The risk of anxiety and depression was low among young people, educated people, and those under effective quarantine, but the risk was high among those who had negative perceptions about their health, stigma, and susceptibility to the disease.


Asunto(s)
Migrantes , Adolescente , Adulto , Ansiedad/epidemiología , Estudios Transversales , Depresión/epidemiología , Humanos , Indonesia/epidemiología , Salud Mental , Pandemias , Prevalencia , Estrés Psicológico/epidemiología , Adulto Joven
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