bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between Cadre Knowledge, Feeding Behaviours and Daily Intake with Changes in Nutritional Status of Undernourished Children in Kawangu Health Centre, East Sumba
Authors: Hara Maria Kareri , Adhi Kadek Tresna , Pangkahila Alex
Published: April 2024

Background and purpose: In 2012, in Eastern Sumba 21% of children under 5 were malnourished; at the Kawangu Health Centre (KHC) it was reported that 3.4% of children were underweight. This study aims to investigate relationships between cadre knowledge, motivation and behavior of child carers with the nutritional status changes of children from KHC.

Methods: A cross-sectional study with 80 samples was conducted. Variables were cadre knowledge, motivation, feeding behaviors and change in nutritional status. Data on cadre knowledge and motivation was collected through a self-administered questionnaire and through interviews conducted with child carers. Anthropometric measurements were taken to assess changes in nutritional status of children. Analysis used univariate and bivariate chi-square test.

Results: Results indicated respondents were aged 26-35 (41.2%), had elementary school education (56.2%), were farmers (91.2%), had experience as cadres for 2 years (53.8%), were trained (72.5%) and had been involved with the program less than <45 days (91.2%). About 55.0% of respondents indicated a high level of knowledge and were highly motivated (86.2%). Carers indicated a fair behaviour change (51.2%), although there was an increase in improvement in nutritional status (63.8%). There was relationship between cadre knowledge and changes in feeding behaviours (p=0.016), but not with cadre motivation (p=0.500). There was an association between feeding behavior (p=0.032) with changes in nutritional status.

Conclusion: The good levels of cadre knowledge and high quality feeding practices impacted positively upon improvements in child nutritional status.
Tobacco Smoke Exposure as Risk Factor in Early Neonatal Death in Mataram, Nusa Tenggara Barat (NTB)
Authors: Musrifa  , Wulandari Luh Putu Lila , Wirawan Dewa Nyoman
Published: April 2024

Objective: To investigate tobacco smoke exposure as risk factor of early neonatal death in Mataram, NTB.

Method: The study design was case control with a total sample of 87 consisting of 29 cases and 58 controls (1:2). Dependent variable was early neonatal death, independent variable was tobacco smoke exposure. Frequency of antenatal visit, family income, delivery complications, anemia and low birth weight were confounding variables. Data were collected through interview and registered cohort data from nine health centres during the period of 1 January-31 December 2013. Data were analyzed by using bivariate and multivariate (logistic regression) to calculate crude OR and adjusted OR.

Result: Results of bivariate analysis indicated that tobacco smoke exposure during pregnancy, extent of exposure ≥3 cigarettes/days during pregnancy, and amount of exposure ≥6 cigarettes/days last 24 hours were 2.75 (95%CI: 0.72-10.50); 2.34 (95%CI: 0.77-7.08); and 2.18 (95%CI: 0.65-7.29) respectively, increasing neonatal death but was not statistically significant. Multivariate analysis indicated that tobacco smoke exposure during pregnancy was 1.32 (95%CI: 0.03-69.90). OR of other variables: low birth weight, family income under IDR 1,100,000,- and delivery complications were 204.39 (95%CI: 20.37-2050.07);  7.86 (95%CI: 1.45-42.83) and 7.55 (95%CI: 1.01-56.38)  respectively.

Conclusion: Tobacco smoke exposure was not statistically significant risk factor, specifically the smoking habits of the husband. Study discovered that low birth weight, family income under IDR 1,100,000,- and delivery complication during birth were statistically significant factors. Further study is needed to confirm these findings.
Retrospective Longitudinal Analysis: Loss to Follow Up Undergoing Antiretroviral Therapy in Kerti Praja Foundation Bali 2002-2012
Authors: Widyanthini Desak Nyoman , Sawitri Anak Agung Sawitri , Wirawan Dewa Nyoman
Published: April 2024

Background and purpose: Lower loss to follow up (LTFU) is one indicator of the success of antiretroviral therapy (ART). In 2013 the Indonesian Ministry of Health reported that the cumulative percentage of LTFU was as high as 17.3%. To date, there has been no retrospective research into LTFU on people living with HIV/AIDS (PLHIV) in Bali, particularly to investigate PLHIV client characteristics.

Methods: This descriptive longitudinal study was conducted to analyze secondary data from records of PLHIV initiating ART between 2002-2012 at Clinic Amertha, Kerti Praja Foundation (YKP). The sample was PLHIV receiving ART at the YKP from 2002-2012 that had first received ART in YKP and had minimum 2 consultations.

Data used was that recorded in the medical records. Variables were: age, gender, occupation, the presence of ART supervisor, and HIV transmission mode. Data were analyzed descriptively to obtain insight into characteristics of LTFU clients per 100 person years (PY). Length of time since LTFU was assessed.

Results: The sample was 548: 77 (14,1%) were LTFU with crude incidence of LTFU at 5.15 per 100 PY. Median time of LTFU was not reached in this study, because of the low outcome incidence. Specific LTFU incidence was higher in women (6.6 per 100 PY), younger age (6.0 per 100 PY), and female sex workers (7.3 per 100 PY). Lack of ART supervisor (9.3 per 100 PY) and homosexual (9.1 per 100 PY) also had higher LTFU incidence.

Conclusion: Specific LTFU incidence was higher in women, younger age, female sex workers, lack of ART supervisor, and homosexual.
Meningkatkan Daya Saing Tenaga Kesehatan dalam Era Masyarakat ASEAN
Authors: Wirawan Dewa Nyoman
Published: April 2024

Selain regulasi dan kebijakan yang telah dikembangkan oleh pemerintah pusat, peran pemerintah provinsi/kab/kota dan lembaga pendidikan juga amat penting untuk meningkatkan daya saing tenaga kesehatan. Pertama, mengembangkan sistem pemantauan (surveilans) tenaga kerja asing di wilayahnya masing-masing, bekerja sama dengan instansi terkait terutama pihak imigrasi. Walaupun telah ada Undang-undang Tentang Pendayagunaan Tenaga Kesehatan Warga Negara Asing di Indonesia, kemungkinan masuknya tenaga kesehatan asing secara ilegal masih amat memungkinkan. Kedua, pemerintah provinsi/kab/kota terutama dinas kesehatan bekerja sama dengan instansi terkait, juga perlu memantau dengan ketat standar mutu lulusan lembaga pendidikan kesehatan di daerahnya masing-masing agar sesuai dengan standar kompetensi yang telah ditetapkan. Hal ini sesuai dengan tanggung jawab dan kewenangan pemerintah provinsi/kab/kota yang diatur dalam Pasal 6 dan 7 Undang-Undang Republik Indonesia Nomor 36 Tahun 2014.5 Ketiga, untuk meningkatkan kesempatan tenaga kesehatan bekerja di luar negeri, pemerintah daerah, terutama dinas tenaga kerja perlu menjalin hubungan dengan para konsulat negara sahabat yang ada di daerahnya masing-masing dan dengan Pelaksana Penempatan Tenaga Kerja Indonesia Swasta (PPTKIS). Hal ini sejalan dengan Rencana Pengembangan Tenaga Kesehatan Kementerian Kesehatan Tahun 2011-2025.8 Keempat, pemerintah provinsi/kab/kota terutama dinas kesehatan perlu menjalin hubungan dan melakukan sosialisasi dengan lembaga pendidikan kesehatan di wilayahnya masing-masing tentang standar dan kualifikasi tenaga kesehatan di negara-negara ASEAN. Hal ini sejalan dengan tujuan ASEAN MRA on Nursing Services yaitu tentang butir exchange information and expertise on standards and qualifications. Kelima, pemerintah provinsi/kab/kota serta semua lembaga pendidikan bidang kesehatan perlu menjalin hubungan dengan negara-negara ASEAN dalam upaya untuk meningkatkan kapasitas tenaga kesehatan dimana hal ini sejalan dengan tujuan ASEAN MRA yaitu tentang tujuan provide opportunities for capacity building and training of nurses. Keenam, semua lembaga pendidikan bidang kesehatan harus meningkatkan kompetensi dan kemampuan Bahasa Inggris atau bahasa asing lainnya bagi para mahasiswanya.
Pemantauan dan Pencegahan Penularan Virus Zika di Indonesia
Authors: Wirawan Dewa Nyoman
Published: April 2024

Upaya lainnya adalah meningkatkan awareness kepada masyarakat dan petugas kesehatan terhadap adanya kemungkinan penularan Virus Zika di Bali/Indonesia. Kepada petugas kesehatan perlu diberikan pemahaman bahwa bila dijumpai adanya infeksi Virus Zika maka diperlukan konseling yang memadai kepada pasien untuk tidak melakukan hubungan seks atau memakai kondom dengan istri/suaminya atau pasangan seksualnya selama 60 hari guna mencegah terjadinya penularan melalui seksual. Bila istrinya sedang hamil maka dianjurkan untuk tidak melakukan hubungan seks atau secara konsisten memakai kondom selama masa kehamilannya. Sama halnya dengan pencegahan penularan infeksi Virus Dengue, pemantauan jentik nyamuk Aedes aegypti dan pemberantasan sarang nyamuk (PSN) amat perlu ditingkatkan.
Sexual Role and History of Sexual Transmitted Infection as a Risk of HIV Seroconversion among Men who have Sex with Men who Attended Bali Medika Clinic Badung, Bali
Authors: Diwyami Ni Putu , Sawitri Anak Agung Sagung , Wirawan Dewa Nyoman
Published: April 2024

Background and purpose: HIV prevalence among men who have sex with men (MSM) increased from 5% on 2007 into 12% on 2011 in Indonesia. High risk sex behaviour was reported associated with HIV seroconversion, however reported research publication about risk factors of HIV seroconvertion among MSM is limited in Indonesia. This study aims to investigate risk factors of HIV seroconversion among MSM.
Methods: Case control study was conducted based on cohort data of MSM who repeatedly visited Bali Medika Clinic, Kuta, Badung, Bali Province between 2011-2015. HIV Seroconversion was defined as MSM with a negative HIV status at the beginning of the observation and became positive on the next visit. Data were analyzed using Kaplan Meier and logistic regression method.
Results: Median time of HIV seroconversion among MSM was 458 days or 1.2 years (IQR=224-699). Multivariate analysis showed that risk factors of HIV seroconversion were repeated STD’s experience in the last 6 months with AOR=8.33 (95%CI: 1.77-89.81); had 1 time STD’s history in last 6 months with AOR=1.91 (95%CI: 1.15-3.83); receptive sexual relationship in the last 6 months with AOR=3,45 (95%CI: 1.68-7.11); and versatile sexual relationship in the last 6 months with AOR=2.37 (95%CI: 1.09-5.13).
Conclusion: STD’s experience, receptive and versatile sexual role are risk factors of HIV seroconversion among MSM.
Risk Factors for Adolescent Pregnancy in Bali: Case Control Study
Authors: Meriyani Dewi Aprelia , Kurniati Desak Putu Yuli , Januraga Pande Putu
Published: April 2024

Background and purpose: Adolescents pregnancy is a public health problem in Indonesia. The 2012 Demographic and Health Survey Indonesia showed that 9.5% women aged 15-19 years had given birth. The aim of this study was to identify risk factors associated with adolescent pregnancy.
Methods: The study was conducted in Kintamani District, Bangli, Bali Province. Design of the study was case control with a total of 96 respondents. The cases were 32 pregnant woman age <20 years and the controls were 64 non married and non pregnant woman age <20 years. The cases were taken from register of pregnant women in Kintamani I and VI primary health care centers. The controls were randomly taken from a list of women in the youth group at the same working area of both primary health care centers. The data collection was conducted by interview in the house of each respondent. The data were analyzed using bivariate (chi square test) and multivariate logistic regression.
Results: Risk factors that found associated with adolescents pregnancy were respondents with peer negative influence (AOR=71.6; 95%CI: 9.4-545.2), respondents who had opportunity to have sexual relationship (AOR=17.7: 95%CI: 3.2-98.2), lack of knowledge about reproductive health and adolescent pregnancy (AOR=12.8; 95%CI: 2.5-66.5) and higher family income (AOR=5.8: 95%CI: 1.3-26.6). Level of education and exposure to pornography was not significantly found associated with adolescent pregnancy.
Conclusion: The negative influence from their peers, opportunity to have sexual intercourse, lack of knowledge and higher family income were found as risk factors of adolescents pregnancy.
The Analysis of Performance Based on Balanced Scorecard at Karangasem Hospital
Authors: Yulianti Putu , Sutarsa I Nyoman , Wijaya I Putu Ganda
Published: April 2024

Background and purpose: Karangasem Hospital has adopted balanced scorecard method in preparation of the strategic plan. The performance evaluation has been done based on accountability report only with the three other perspectives have never been analysed before. This study was conducted to assess those four perspectives.
Methods: Cross-sectional survey was carried out among 110 inpatients and 95 employees which were selected conveniently. The data were collected by interviews using questionnaire. The data were analyzed with kartesius graph to get each item of patients and employees satisfaction that need to be priority. Secondary data analysis conducted to know the tendency of those four perspectives.
Results: Based on the assessment of the four perspectives showed that the overall score is 44.7%. It is defined as sufficient category. This also can be observed that each perspective of finance, customers and internal business process included in sufficient category. Their scores are 16.65%, 12.5% and 15.62%. Meanwhile, for the learning and growth perspective showed as weak category (0). Kartesius graph analysis showed that two items of patient’s satisfaction have to do with procedure and quick service need to be concerned. However, the employees’ satisfaction showed that there are five sub items which need to be concerned. They are quick response, management support and working environment.
Conclusion: The performance of Karangasem Hospital based on scorecard is in the sufficient category and patients/employee’s satisfaction still need to be concerned on certain items.
Determinants of Mortality among Low Birthweight Infants During Hospitalization in Karangasem District Hospital
Authors: Duara I Ketut , Wirawan Dewa Nyoman , Januraga Pande Putu , Sawitri Anak Agung Sagung
Published: April 2024

Background and purpose: Infant mortality rate in Indonesia is still high and is largely related to low birthweight (LBW) infants. Previous studies reported the sociodemographic and clinical factors as determinants of mortality of LBW infants, but rarely examined factors related to their health services. This study aims to determine the demographic, clinical and health services as determinants of mortality of LBW infants during hospitalization.
Methods: This study was a retrospective using cohort data of medical record of LBW infants in Karangasem Hospital since January 2012 to October 2014. Logistic regression was done to determine the relationship between demographic, clinical and health services factors with LBW infants’ mortality.
Results: The proportion of mortality among LBW infants during hospitalization was 12.12%. Most parents (64.6%) live in good access to health services. The proportion of female infants (51.4%) was higher than male. LBW infants who were born in hospital (85.7%) greater than born outside hospital. Vaginal delivery (75.3%) was greater than C-section. Preterm infants (57.1%) was greater than at term with median of birthweight was 2100 grams. Proportion of asphyxia, respiratory distress syndrome (RDS), sepsis, hypoglycemia and hypothermia, respectively 24.1%, 4.66%, 0.78%, 7.92% and 3.73%. Variables associated with LBW mortality were increasing of 50 grams of birthweight, asphyxia, RDS and referred infants.
Conclusion: The mortality of LBW infants during hospitalization was 12.12% with increasing of 50 grams of birthweight,
Predictors of treatment interruption among tuberculosis patients in public health centres in Bali, Indonesia
Authors: Farmani Putu Ika , Wirawan Dewa Nyoman , Sawitri Anak Agung Sagung , Putra I Wayan Gede Artawan Eka
Published: April 2024

Background and purpose: Tuberculosis treatment interruption (TB TI) is one factor that leads to treatment failure, tuberculosis (TB) drug resistance and drop out. The purpose of this study is to identify the incidence and the predictors of TB TI in public health centres (PHCs) in Bali.

Methods: A retrospective longitudinal study was conducted using secondary data of 644 cohorts of TB patients on the first regiment who enrolled in 11 PHCs in Denpasar Bali during 2011-2012. Information from TB program officers in PHCs was also obtained to determine the differences within the practical implementation of TB treatment. Data were analysed using Kaplan Meier and Cox Proportional Hazard Regression.

Results: The study revealed that 378 patients experienced TB TI with the total events of 535. The incidence rate of TB TI event was 5.1 per 1.000 person days and the median time was 56 days (IQR: 56-57). Predictors of the TB TI were male (AHR=1.22; 95% CI: 1.02-1.45; p=0.027) and a more flexible schedule to take the medicine (AHR=1.47; 95%CI: 1.22-1.76; p<0.0001).

Conclusions: The implementation of fixed schedule and shortened time lapse for patients to take TB drug will enable more close contact between patients and health providers. Intensive adherence counselling especially tailored for male patients is also required.
Correlation between Demographics, Clinical and Risk Factors for HIV Infection with HIV/TB Co‑infection in Amertha Clinic Kerti Praja Foundation Denpasar
Authors: Nyoko Yuneti Octavianus , Putra I Wayan Gede Artawan Eka , Sawitri Anak Agung Sagung
Published: April 2024

Background and purpose: HIV infection increases the risk of developing tuberculosis (TB), as TB infection increases the progression of HIV. In Bali, HIV/TB co-infected patients have increased from 26% in 2012 to 30% in 2013. Study on factors related with the occurrence of HIV/TB co-infection is limited in Indonesia. This study aims to determine the correlation between demographics, clinical and risk factors for HIV infection with HIV/TB co-infection in Amertha ClinicKerti Praja Foundation Bali.Methods: The study design was cross-sectional using secondary data of patients with HIV/AIDS who were receiving antiretroviral therapy (ART) from 2002-2012. Independent variables were demographics: gender, age, education level, working status, and presence of ART supervisor; clinical: hemoglobin count, weight, CD4 count; and risk factor for HIV infected. The status of HIV/TB co-infection was the dependent variable. Data was analysed using univariate, bivariate (chi-square) and multivariate (cox regression).Results: From the 531 patients, the majority were male (57.6%) and aged ≥31 years (50.8%). About 5.5% of patients experienced HIV/TB coinfection. Multivariate analysis indicated that the variables correlating with HIV/TB co-infection occurrence were CD4 count at baseline ≤200 cell/mm3 (PR=10.34; 95%CI: 1.39-76.69; p=0.022) and risk factor for HIV infected with IDU (PR=3.27; 95%CI: 1.56-6.88; p=0.002).Conclusion: Patients with CD4 count ≤200 cell/mm3 and HIV infected by IDU have correlating with HIV/TB co-infection.
Internal and External Perspectives on Quality of Healthcare Services at Sanglah General Hospital Denpasar
Authors: Sundari Made Nopy Diah , Indrayathi Putu Ayu , Kuswardhani Raden Ayu Tuty
Published: April 2024

Background and purpose: Customer satisfaction is a primary indicator of the quality of public healthcare services. This study investigated internal (hospital staff) and external (hospital clients) perspectives in order to gain insight into the quality of care at Sanglah General Hospital.  

Methods: The study used both qualitative and quantitative methodologies with 11 informants and 106 respondents. Qualitative data obtained through in-depth interviews with hospital staff were analyzed thematically. Quantitative data obtained through self-administered questionnaire were analyzed using univariate analysis.

Results: Informants from the qualitative data collection stated that Sanglah General Hospital has a relatively high level of service and that existing structures to mitigate issues are in place, which act as reinforcing factors.  Data from the quantitative survey indicated that clients were satisfied with the quality of service (ServQual), with an overall percentage of 83.82%.

Conclusion: Further efforts could be made in order to improve healthcare provision at Sanglah Hospital, particularly from the perspective of hospital facilities, staff support and increased implementation of clinical governance.
Employment and Education as Risk Factors of Cataract Incidence on Patients Treated in Eye Health Centre Mataram City West Nusa Tenggara
Authors: Ulandari Ni Nyoman Santi Tri , Astuti Putu Ayu Swandewi , Adiputra I Nyoman
Published: April 2024

Background and purpose: The purpose of the study was to determine the risk factors of employment, education and other risk factors on the occurrence of cataracts in patients seeking treatment at Eye Health Center in the City of Mataram, West Nusa Tenggara.

Methods: The study was a case-control with a sample of cases and controls, respectively amounted to 40 (1: 1). The dependent variable was patients with cataract and independent variables were: education, employment, income, diabetes mellitus, history of cataracts, smoking behavior, and exposure to smoke and sun exposure. Data were collected by means of interviews using questionnaires and tracking documents of patients’ medical records. Data analysis was performed using univariate, bivariate to determine the comparability between cases and controls and to see the crude of OR. Multivariate analyses were performed to determine the adjusted OR.

Results: Four variables were found to be risk factors to the occurrence of cataracts: education, income, occupation and exposure to sunlight with each crude OR of 10.50 (95% CI: 3.39 to 32.52); 6.23 (95% CI: 2.35 to 16.51), 10.52 (95% CI: 3.56 to 31.12); and 3.11 (95% CI: 1.25 to 7.78). While diabetes mellitus, family history of cataracts, smoking behavior and exposure to smoke was not statistically proven as a risk factor for cataracts. The multivariate analysis showed that most risk factors played a role in the occurrence of cataract was employment with OR=9.81 (95% CI: 1.85 to 52.02) and education with OR=6.53 (95% CI: 1.42 to 29.92).

Conclusion: Employment and education were significant risk factors to the occurrence of cataracts in patients who visited the Eye Health Center in the City of Mataram, West Nusa Tenggara.
The Relationship between Paramedic Competency, Teamwork and Career Development with Quality of Service at Mengwi I Community Health Centre
Authors: Naya Alit , Ani Luh Seri , Wijaya I Putu Ganda
Published: April 2024

Background and objective: Recent survey indicated that patient opinion of services at Mengwi I Community Health Centre was low and there was noticeable decline in patient visits. This study aims to investigate the issues related to the quality of health services given by the paramedics.

Methods: A cross sectional study was conducted with 38 paramedics on duty at the outpatient unit. They were interviewed to obtain the data on their opinions about the quality of their service, competence, teamwork and career development opportunities. Chi square test was used for bivariate analysis and logistic regression for multivariate analysis.

Results: The results of bivariate analysis indicated there was significant association between the paramedics’ quality of service with the competence, teamwork and career development (p<0,001). Multivariate analysis indicated that the paramedics’ competence (p=0,035) and development of career (p=0,042) are related to the paramedics’ quality ofservice.

Conclusion: The quality of service of paramedics at Mengwi I Community Health Centre with the paramedics’ competence and development of career.
Nutritional status and associated factors in under-five children in Lembar Village West Lombok, Indonesia
Authors: Dwijayanti Widya , Wirawan Dewa Nyoman , Ani Luh Seri , Utami Ni Wayan Arya
Published: April 2024

Background and purpose: Studies on determinants of nutritional status in under-five children in Indonesia have been widely explored. However, most studies utilised only one out of three nutritional status indicators–weight/age, height/age, or weight/height. These studies also show inconsistent results. This present study aims to examine nutritional status in under-five children by using all three indicators and associated factors which include mother’s characteristics, nutrition intake, and child’s history of infectious diseases.
Methods: A cross-sectional study was conducted with a total sample of 100 under-five children who were randomly selected. Data on the mother’s characteristics, nutrition intake, and child’s history of infectious diseases were collected through structured interview with the mother, while data on nutritional status were obtained through measurements. Data were analysed using logistic regression to identify association between the nutritional status of under-five children with the mother’s characteristics, nutrition intake, and child’s history of infectious diseases.
Results: There was no association between the nutritional status of under-five children based on weight/age, height/age, and weight/ height with the mother’s characteristics and nutrition intake. However, there was an association between the nutritional status of under-five children and child’s history of infectious diseases with an adjusted odd ratio (AOR)=41.0 (95% CI: 12.10-139.14) for weight/age, AOR=3.52 (95%CI: 1.53-8.05) for height/age, and AOR=10.69 (95%CI: 1.31-87.11) for weight/height.
Conclusions: Child’s history of infectious diseases is the only determinant associated with nutritional status in under-five children based on weight/ age, height/age, and weight/height. Prevention measures are required to prevent infection among children by improving environmental hygiene as well as providing prompt treatment for infectious diseases especially diarrhoea and upper-respiratory tract infection.
Readiness to change towards accredited public health centres (PHCs) in West Lombok
Authors: Santiana I Made , Nopiyani Ni Made Sri , Duarsa Dyah Pradnyaparamita
Published: April 2024

Background and purpose: The 2016 Report of Performance Accountability of Government Agencies, Ministry of Health of Indonesia showed only a small proportion of public health centres (PHCs) are accredited. In West Lombok District, some PHCs are not accredited. This study aims to examine factors associated with PHC’s staff readiness for accreditation.
Methods: A cross-sectional survey was employed involving seven non-accredited PHCs. A total of 165 out of 310 PHC’s staff were recruited using a systematic random sampling. Data was collected from February to March 2017. Self-administered questionnaire was used to collect data on socio-demographic characteristics, duration of service, content, process, and context changes, individual attributes, and readiness to change. Logistic regression was applied to examine the association between readiness to change with independent variables.
Results: As many as 72.1% of respondents are ready to change. From the change efficacy and appropriateness dimensions, as many as 46.1% and 97.0% of respondents are ready to change. Multivariate analysis shows an association between readiness to change with administrative systems (AOR=4.47;95%CI:2.05-9.74) and working procedure (AOR=2.95; 95%CI: 1.19-7.30). There is no significant association between readiness to change with technological improvement, promotional strategy, staff engagement, organisational commitment and managerial support from health offices.
Conclusions: The readiness to change among PHC’s staff is high. The availability of working procedure and administrative systems improves PHC’s staff readiness for the accreditation. These findings suggest the importance of inclusion of all PHC’s staff during the accreditation processes.
Association between breakfast-eating habit and attention-concentration in primary school children: a cross-sectional study in Badung District
Authors: Sukmandari Ni Made Ari , Septarini Ni Wayan , Pinatih Gede Ngurah Indraguna
Published: April 2024

Background and purpose: One of the main benefits of breakfast eating habit for schoolchildren is to maintain the attention concentration. The current trend shows a steady decline in the breakfast-eating habit among primary school children. This present study aims to examine the association between breakfast-eating habit and attention-concentration in primary school children.
Methods: A cross-sectional study was conducted involving 160 primary school students year 5 and 6. Samples were selected from six public primary schools within two villages. There were a total of 16 classes of year 5 and 6 in these six schools, and five classes were selected randomly. All students from the selected classes included in the study. Attention concentration was measured using a digit symbol test, and breakfasteating habit and total calories intake were measured using the recall 24 hours and a standardised questionnaire. Multivariate analysis with logistic regression was employed to examine the association between breakfast-eating habit and attention-concentration.
Results: The majority of students were found to have good concentration (60.63%), with breakfast-eating habit (75.00%), and consumed sufficient amount of calories (53.13%). Our multivariate analysis found a significant association between breakfast-eating habit and attention-concentration among schoolchildren (AOR=14.0; 95%CI: 4,9–67,8).
Conclusions: Students with breakfast-eating habit tend to have a good attention-concentration. The total calories intake during breakfast is not associated with attention-concentration among primary school students in Badung District.
Relationships Between Personality Domains and Creative Praxis Pedagogy of Ensemble Teachers
Authors: Heil Leila , Taft Seth A.
Published: April 2024

The purpose of this study was to investigate the relationship between personality domains and pedagogy of creative praxis, specifically composition. The Big Five NEO-FFI-3 personality inventory and a researcher-created survey were distributed to practicing public school music educators (n = 46) to determine their Openness, Agreeableness, Neuroticism, Extraversion, and Conscientiousness as well as information about their creative praxis pedagogy approaches. NEO-FFI-3 personality domain indicators were compared with teaching approach classifications. Two significant relationships existed: (a) a quasiformal, inclusive approach was related to Openness, and (b) an approach favoring individual instruction was related to Neuroticism. Furthermore, comfort with creative praxis pedagogy was related to participants’ experience with creative praxis but not years of teaching experience. Preservice and in-service music teachers should be given opportunities to develop confidence with creative praxis and its pedagogy in ways that are authentic to their personalities.
Vocabulary Learning Strategies of English as a Foreign/Second Language
Authors: Zhang Tiantian , Liang Liyilan
Published: April 2024

English has become the most widely spoken language in the world, and memorizing vocabulary is a fundamental step in acquiring this language. Many English as a foreign language (EFL)/English as a second language (ESL) learners have difficulty remembering new words, so vocabulary learning strategies are studied globally. This literature review examined international research across ages and discussed three learning strategies: the keyword method, pictorial association, and the mind-mapping method. Results suggested that the three learning strategies effectively improved students vocabulary recall and retention, and learning strategies help EFL/ESL learners with vocabulary studies.
Unraveling Fertility Intention in Highly Populated Chinese Cities: The Role of Working Time and Job Satisfaction
Authors: Wang Adam Sidney
Published: April 2024

In 2015, the Chinese Central Government implemented a two-child policy, a family planning policy that encourages each couple to have two children, relaxing previous birth restrictions under the one-child policy. However, the new measures did not result in the expected wave of births. Even after the implementation of the three-child policy in 2020, Chinas fertility rate is still 1.3, far below the replacement level. Since the effectiveness of pro-natalist policies such as financial incentives and parental leave in encouraging women to have more children is also questionable, the research intends to propose alternative demographic solutions to raise the total fertility rate. This paper argues for combating working overtime and raising work satisfaction to raise fertility intention for Chinese women in highly populated cities. Obtaining data from questionnaires completed by women in eight megacities in China, the study conducts Spearman Correlation on variables in the data set. Results indicate that women have a large workload each week, relatively positive work satisfaction, and a low desire to have children both currently and prospectively. Meanwhile, correlation analysis suggests a negative correlation between work time and fertility intention. Further investigation on work satisfaction suggests that job security and benefits in government-affiliated institutions influence the number of existing children greatly, while income and promotion opportunities stand out to be the most important factors in impacting both existing and planned child numbers in the significance test. Based on the findings, the study proposes to launch public awareness campaigns, create regulations to enhance equal promotion opportunities in enterprises, and tailor regional initiatives to address local fertility changes. Future studies can expand the scope to include male perspectives to provide a comprehensive understanding of fertility intention in populated cities that have stressful work environments.
Cultural Variation in In-group Bias among Chinese International Students
Authors: Wang Weiting
Published: April 2024

In-group bias may implicitly affect Chinese international students' social interaction, making it difficult to demonstrate its impact. Thus, this project investigates how in-group bias affects the interactions between Chinese international students and local students. Through a literature review, it is found that people are more likely to discriminate against out-group members than in-group members. To explore the impact of in-group bias, an experiment is designed to measure Chinese students' stress levels when they conduct self-introduction in front of other students. The participants will be divided into three groups with different Chinese to non-Chinese phantom ratios. The participants' stress levels will be assessed through their voice and facial expressions by trained coders. The expected result is that the participants' stress level decreases as the percentage of Chinese phantoms increases.
The Influence of Afterschool Sports on American High School Students
Authors: Lin Yuting
Published: April 2024

In this article, we explore the factors associated with afterschool sports for American high school students. About 20 American high school students will attend an interview. The students are from the same school, with the same race and background but different afterschool sports. Findings from semi-structured interviews uncovered two themes that participants used in explaining their influence of afterschool sports. The work shows (1) Through sociocultural theory, it shows the important influence of afterschool sports in peer effects, sport-friend relationships and social networks and helps students to build a social network in the high school; (2) afterschool sports can influence students in their physical fitness and mental health. This paper will help American high school students choose their afterschool sports and show them the important influence of afterschool sports in their daily lives.
Exploring Foreign Language Anxiety in the Listening and Speaking of Learning English as a Second Language
Authors: He Siwei , Wang Shuheng
Published: April 2024

Foreign language learning anxiety, a psychological and emotional variable, significantly impacts the effectiveness of L2 learners' acquisition. Listening and speaking are the language skills that take up the first two forms in second language learning and the branches that cause the most anxiety among L2 learners. Due to their unique characteristics, reviewing foreign language anxiety in listening and speaking is significant and insightful. This paper examines previous research on listening and speaking anxiety as a second language, analyzes relevant sources and scales, summarizes progress made in these fields, and provides practical strategies for reducing such anxiety. Reviewing and summarizing previous studies, this paper aims to provide language learners with a correct and comprehensive understanding of listening and speaking during language acquisition. Additionally, foreign language instructors are expected to thoroughly comprehend contributing factors to anxiety and implement effective pedagogical strategies, which will have significant implications for enhancing English instruction.
A Review on Foreign Language Education Policies in China from 1949 to 2023
Authors: Liu Yueming
Published: April 2024

This paper reviews on the topic of foreign language education policies in China from 1949 to 2023. It mainly focuses on English and Russian. In this paper, the timeline is separated by three important timepoint. The first important section is in 1949. As the People's Republic of China came into being, complicated and convoluted foreign language education policies in China started to emerge. The second important section is in 1978. In this year, Chinese government launched the famous national strategy of reform and opening up, and thus many changes in Chinese foreign language education policy happened. The third important section is in 2021, and in this year, Chinese government launched the Double Reduction Policy. This is a policy aiming to alleviate students' homework burden and off campus training burden in the compulsory educational stage. This policy uses various kinds of measures to reduce students' burden in academic learning, help families who cannot afford luxurious after-class tutoring fee, and enable children to have more time and space needed for all round development. In general, this paper concludes the development of foreign language education policies in China from 1949 to 2023 and gives some points in economic and historical effects to English and Russian learning during this historical process.
The Influence of Peer Relationships on Children's Social Development
Authors: Chen Changyu
Published: April 2024

Children's peer relationship plays a crucial role in the development process of children, and having good peer communication skills can help children shape good personality qualities and promote children's positivity. The formation of optimistic emotions and emotions allows children to carry out social cognition and social skills, thereby enabling the development of children's sociality. In the process of the development of children's peer relationships, peer communication on children's social cognition and social communication ability now has a more significant impact, children's peer relationship on children's social development problems based on the reality of domestic and foreign research, need to be further solved, so the impact of children's peer relationship on social development is worth in-depth development. Therefore, the research on the influence of children's peer relationships on social development has specific practical and theoretical significance. This paper first explains the concept of children's peer relationships and social development, secondly describes the influencing factors of children's peer relationships, and finally elaborates on the influence of children's peer relationships on children's social development.
Investigating the Impacts of Learning Latin on the Acquisition of Romance Languages in English Speakers
Authors: Zhang Ray
Published: April 2024

This literature review examines the impacts of learning Latin on acquiring Romance languages in English speakers. As an ancient and foundational language for many modern Romance languages, Latin has been hypothesized to influence the learning and comprehension of related languages positively. Many sources suggest a positive transfer effect between Latin and the Romance languages; however, some studies are skeptical of the practicality of using Latin as a pathway to multi-lingualism, instead suggesting more modern Romance languages to take its place. Nonetheless, the implications of these findings shed light on language education strategies and curriculum design, providing valuable insights for language learners and educators alike. Further research is recommended to explore the mechanisms underlying the observed transfer effects and validate or invalidate the potential benefits of learning Latin in the acquisition of Romance languages.
Impact of Agricultural Mechanization on Grain Production in China
Authors: Wang Lintian
Published: April 2024

The main purpose of this article is to investigate the relationship between agricultural mechanization and grain production. Our main country of study is China because it is a large agricultural country, and the choice of China is representative and meaningful. The methodology chosen in this paper is to de-trend the data, which helps us to put aside the time factor to see the relationship that exists between them in a more objective and clear way. The time period of the data that be collected is from 2003 to 2021 because this time period is the period of rapid development of agricultural mechanization in China. The author also details the history of agricultural mechanization in China in the article. Finally, it can be seen that based on the results, agricultural mechanization and grain yield are positively and strongly correlated, and mechanization has a strong impact on grain yield. This paper also provides some policy recommendations for agriculture and farmers based on our research; it can be believed that the policies can really help agriculture because a lot of research has been conducted. The author also hopes that this article will be of some help to readers.
The Realistic Dilemma and Reform Path of IHR2005
Authors: Dai Hui
Published: April 2024

The International Health Regulations2005 (IHR2005) plays a significant role in the governance of global public health security. Nevertheless, when addressing the global public health crisis triggered by the 2020 novel corona virus epidemic, the IHR2005 shows some shortcomings. For example, the treaty cannot effectively coordinate the timely implementation of health measures such as epidemic prevention surveillance, situation assessment, technical cooperation and financial support. Using the case analysis, the literature search and other research methods, the paper analyzes the dilemmas of IHR2005, such as the ambiguity of the text itself, the limitation of the scope of application, and the failure to completely abandon the national centralism. To solve these problems, this paper put forward three solutions: The first is to reconstruct the text, and to name only a few controversial places that can be directly converted into text. The second is to reconstruct the mechanism, like establishing a more mighty system on the basis of the original mechanism. The third is to reconstruct the institution, which should strengthen technical cooperation with non-state actors while adjusting regulations that are not adapted to the development of The Times, and consolidate the leadership position of the World Health Organization (WHO).
The Role of Memory Enhancing Techniques in Learning--Examining the Effects of Item-level Brain Training Techniques on Learning
Authors: Quan Kexin
Published: April 2024

Brain training techniques are commonly used to enhance an individuals learning and memory, especially in classroom teaching and self-directed learning contexts. Among a range of techniques, the item-level methods that focus on boosting memory for a specific item are the most well-known and widely applied ones. In this work, the mechanisms underlying two item-level brain training techniques, spaced repetition and retrieval practice, are investigated. Studies have proved that learners who are trained according to a spaced repetition schedule are prone to show better acquisition of language and science concepts compared to those who learn under mass conditions. Yet, the method currently relies on somehow primitive algorithms. Therefore, the optimal time interval for the second exposure to a learnt content could vary primarily among individuals. Reviewing pieces of information through retrieval practice, based on the testing effect, also leads to better performance in final assessments in most cases. Frequent testing with relatively few questions each time seems to produce the best results. However, most of the research on these two techniques up to now is in semantic learning scenarios such as language acquisition, so the evidence for determining the effectiveness of either method on other types of learning is somehow few.
The Role of Parenting Style and Childhood Friendship in Predicting Risk of Adulthood Psychopathy
Authors: Gu Xinyuan
Published: April 2024

In this work, we investigated the role of parenting style and childhood friendship in predicting the risk of adulthood psychopathy. This paper concluded that negative parenting, parental psychopathic traits and antisocial friendship played a vital role in shaping the antisocial behaviour of their offspring. Additionally, there was an inconsistent relationship between parental psychopathic traits (mainly focusing on conduct problems and callous-unemotional traits), negative parenting and offsprings psychopathic traits, highlighting the importance of sensitive caring from parents before adolescence. However, childrens empathy levels have a moderating effect on their perceptions of parenting which directly affected the development of psychopathic traits. Likewise, childhood friendship can either alleviate or induce childrens antisocial behaviour, and opposite-sex friends were found to be positively correlated with disruptive behaviours. Unexpectedly, the quality of friendships, peer pressure, and positive parenting have a profound impact and they interrelate with one another in the formation of individual behaviours. By considering these factors collectively, this work gained the capacity to predict the probability of children developing psychopathy, and potentially utilize this knowledge for intervention purposes.
The Relationships Between Learning Styles and L2 English Learning
Authors: Chen Jinyan , Yang Wenyuan
Published: April 2024

The paper discusses the relationship between learning styles and L2 English learners. The authors mainly focus on how personality and autonomous learning abilities influence learning styles and learning performance. The authors read through pervious study and find that there are gaps in studies of personality and autonomous learning abilities. Then, two pieces of questionnaires are conducted through online platform. According to the questionnaires, for personality, students of judgement and perceiving personalities prefer different learning styles, achieving different English performance. Their choices are always related to their characteristics of personalities. For autonomous learning abilities, the author investigates students' abilities to learn independently by comparing their English grades, attempting to infer the relationship between English learning and autonomous learning. Authors findings have new insight in the field of learning styles of L2 English learners. But the questionnaires only collect small number of students and the results lack qualitative support.