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PURPOSE: We aimed to investigate the association of birth weight with the risk of diabetes mellitus in adolescence and early adulthood in the Indonesian population. METHODS: This study analyzed data from the Indonesian Family Life Survey, a longitudinal study of the Indonesian population with repeated measurements at 3 time points (1997, 2007, and 2014). The subjects observed were children aged 0-59 months in 1997, who were 10-15 years old in 2007, and 17-22 years in 2014. We performed a generalized linear model to investigate the association between birth weight at baseline and the level of hemoglobin A1c (HbA1c) at the 2 follow-up periods. We adjusted the association for the characteristics of the children, parents, and household. RESULTS: The mean±standard deviation level of HbA1c was 7.35%±0.95% in 2007 and decreased to 5.30%±0.85% in 2014. The crude ß (95% confidence interval [CI]) of the association between birth weight and HbA1c was 0.150 (-0.076, 0.377) in 2007 and 0.146 (-0.060, 0.351) in 2014. After adjustment for the sociodemographic characteristics of the children, parents, and confounding factors, the adjusted ß (95% CI) was 1.12 (0.40-1.85) in 2007 and 0.92 (0.35-1.48) in 2014. The HbA1c of the parents, father's employment status, percentage of food expenditure, and underweight were the covariates that had significant associations with HbA1c. CONCLUSION: HbA1c level was higher in adolescence than in early adulthood. Birth weight was associated with HbA1c level in both periods. The HbA1c of the parents, father's employment, percentage of food expenditure, and underweight partly explained the association between birth weight and the HbA1c level.
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BACKGROUND: Dengue fever control in the tropical island of Bali in Indonesia carries important significance both nationally and globally, as it is one of the most endemic islands in Indonesia and a worldwide popular travel destination. Despite its importance, the spatial and temporal heterogeneity in dengue risk and factors associated with its variation in risk across the island has not been not well explored. This study was aimed to analyze for the first time the geographical and temporal patterns of the incidence of dengue and to quantify the role of environmental and social factors on the spatial heterogeneity of dengue incidence in Bali. METHODS: We analyzed retrospective dengue notification data at the sub-district level (Kecamatan) from January 2012 to December 2017 which obtained from the Indonesian Ministry of Health. Seasonality in notified dengue incidence was assessed by seasonal trend decomposition analysis with Loess (STL) smoothing. Crude standardized morbidity rates (SMRs) of dengue were calculated. Moran's I and local indicators of spatial autocorrelation (LISA) analysis were employed to assess spatial clustering and high-risk areas over the period studied. Bayesian spatial and temporal conditional autoregressive (CAR) modeling was performed to quantify the effects of rainfall, temperature, elevation, and population density on the spatial distribution of risk of dengue in Bali. RESULTS: Strong seasonality of dengue incidence was observed with most cases notified during January to May. Dengue incidence was spatially clustered during the period studied with high-risk kecamatans concentrated in the south of the island, but since 2014, the high-risk areas expanded toward the eastern part of the island. The best-fitted CAR model showed increased dengue risk in kecamatans with high total annual rainfall (relative risk (RR): 1.16 for each 1-mm increase in rainfall; 95% Credible interval (CrI): 1.03-1.31) and high population density (RR: 7.90 per 1000 people/sq.km increase; 95% CrI: 3.01-20.40). The RR of dengue was decreased in kecamatans with higher elevation (RR: 0.73 for each 1-m increase in elevation; 95% CrI: 0.55-0.98). No significant association was observed between dengue RR and year except in 2014, where the dengue RR was significantly lower (RR: 0.53; 95% CrI: 0.30-0.92) relative to 2012. CONCLUSIONS: Dengue incidence was strongly seasonal and spatially clustered in Bali. High-risk areas were spread from kecamatans in Badung and Denpasar toward Karangasem and Klungkung. The spatial heterogeneity of dengue risk across Bali was influenced by rainfall, elevation, and population density. Surveillance and targeted intervention strategies should be prioritized in the high-risk kecamatans identified in this study to better control dengue transmission in this most touristic island in Indonesia. Local health authorities should recommend travelers to use personal protective measures, especially during the peak epidemic period, before visiting Bali.
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This research compared the effectiveness of two techniques for administering group counseling focused on values clarification: modeling vs. role play. Effectiveness was measured in terms of participants' empathy at three time points, using a mixed factorial design. Participants were 40 students from a middle school in Mataram, Indonesia, who completed the Questionnaire of Cognitive and Affective Empathy (QCAE). Results of three ways mixed ANOVA showed that the two techniques of administering group counseling focused on values clarification were both effective in increasing participants empathy, although modeling appeared to be the most effective approach and is likely to be more efficient. Female students empathy was higher than males, but there was no evidence that one group counseling technique worked better for girls than for boys. The results are discussed in terms of their implications for future studies and intervention
Esta investigación comparó la efectividad de dos técnicas para administrar terapia de grupo basada en la clarificación de valores: técnica de modelado frente a juego de roles. La efectividad se midió mediante la empatía de los participantes en tres momentos, empleando un diseño factorial mixto. Los participantes fueron 40 estudiantes de una escuela intermedia de Mataram, Indonesia, que cumplimentaron el Cuestionario de Empatía Cognitiva y Afectiva (QCAE). Los resultados de tres formas mixtas de ANOVA mostraron que las dos técnicas de administración de terapia de grupo centradas en la clarificación de valores fueron efectivas para aumentar la empatía de los participantes, aunque la técnica de modelado parecía ser el enfoque más eficaz y probablemente el más eficiente. La empatía de las estudiantes femeninas era más alta que la de los varones, pero no había evidencia de que una técnica de terapia de grupo funcionara mejor para las chicas que para los chicos. Se discuten los resultados en cuanto a su implicación para el estudio e intervención futuros
