bluuebunny/crossref_metadata_2025_split huggingface dataset:
Magnitude of Out of Pocket Health Expenditures and Associated Factors among Civil Servants
Authors: Geremew Mekuanenet , Gedefaw Molla , Tsegay Girmay , Kassa Getachew Mullu 
Published: November 2019

<p>In Ethiopia, as other developing countries, public health care is provided at nominally low prices and free to those that does not afford to pay. But the health care consumer population is still to make considerable amount of out-of-pocket health expenditure for various reasons. A cross sectional quantitative study from January to May 2013 was done. Study population was civil servants in Debre Markos town. A total of 467<strong> </strong>study participants were selected by using simple random sampling method. Data were collected by trained high school graduates and then the collected data were entered into a computer by using Epi-Data version 3.1 and analysis was performed by using SPSS version 16 for windows. Possible associations between out of pocket health expenditure and its predictors were analyzed by using both bivariate and multivariate analysis.<strong> </strong>The mean age of the study participants were 41 years. Majorities were between 25 and 44 years of age, 258 (55.2%). The level of education among the study participants indicated that most 380 (81.4%) were graduates of higher education (HE) and majority were Orthodox Christian which accounted 446 (95.5%) followed by Muslims 13 (2.8%). To put it briefly, the study identified that the median of out of pocket health care expenditure accounted 8.26% of total household income. Health status of the household (with or without chronic illness), debt on any of the household, house on construction owned by any household member, educational fee for at least one member of the household and predominantly used health institution were the associated factors that have significant impact on household out of pocket health expenditure. <strong>T</strong>here is economic burden as a result of health care at household level. Based on the results, the recommendation was introducing social health insurance for all civil servant employees in the study area.</p>
The Difference of Satisfaction Level in BPJS Health Insurance Patient and Non Insurance Patient toward Health Service
Authors: Dewi Arlina , Ramadhan Naufal Kurnia 
Published: November 2019

National Health Insurance (JKN) developed in Indonesia is part of the National Social Insurance System (SJSN). One way to assess the services quality is to measure the patient satisfaction level. This research is a quantitative research with the <em>cross sectional </em>research design. The subjects of this research were the BPJS health insurance patients and non insurance patients with 200 people as the samples. The data was analyzed by the independent t-test, gap analysis,<em> CSI (Customer satisfation index) </em>and <em>IPA (Importance performance analysis).</em> The result showed that significant (ρ value &gt;0,05) in all dimensions which mean that there is no difference of patient satisfaction level in Social Security Organizing Body (BPJS) participants and non insurance patients toward health services in Negara General Hospital. The biggest satisfaction in non insurance patients is on the <em>Assurance</em> variable (-1,002) and the smallest satisfaction is on the <em>Tangibles</em> variable<em> </em>(-1,357) and the biggest satisfaction of BPJS health insurance patients is on <em>Assurance </em>variable (-1,085) and their smallest satisfaction is on <em>Responsiveness</em> variable<em> </em>(-1,367). The non insurance patients gap is (-0,217) and the BPJS health insurance patients gap is (-1,206), both of them were classified into low satisfaction level. The result of Importance performance analysis value of non insurance patient showed <em>Responsiveness</em> attributes that should be prioritized and improved while in BPJS health patients showed <em>Responsiveness</em> and <em>Reliability</em> attributes that should be prioritized and improved by Negara General Hospital.
Investigations of Latrine Coverage and Associated Factors Among Debretabor Town, Amhara Region North West Ethiopia
Authors: Tafere Yilkal , Woldie Mirkuzie , Assefa Henok 
Published: November 2019

<span style="color: #000000; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 10px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">Studies in a number of countries have shown that wherever inappropraite waste disposal morbidity and mortality rates are high. Although latrine coverage is an important indicator for measuring success of the health service program; data on latrine coverage scarce in the study area. Objective: To investigate latrine coverage and associated factors in among households of Debretabor town, Amhara region, Ethiopia.<span> </span></span><span style="color: #000000; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 10px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">Methods: A community based cross sectional study was conducted in Debretabor town from September 1-30, 2013. A total of 422 households were included in the study using systematic sampling technique. Data were collected using structured questionnaire and analyzed using SPSS version 16.0. Degree of association between independent and dependent variables was assessed with a 95% confidence level and p-value less than 0.05 was used to detect statistical significance. Result: In this study. Ninety three point five percent of households have latrine. Graduated as model family was predictor for availability of latrine (AOR= 3.18,). Income and house ownership were also found to be predictors for availability of latrine (AOR=3.70), (AOR=8.46), respectively. Educational status of respondents was found to be predictors for availability of latrine (AOR= 2.65). Conclusion: latrine coverage was relatively lower from the national target of 100%, still there are households that use open defication. Educational status, house owner shipe, income and graduated as model family were main factors affecting latrine availability. Improving socio economic status of households, provision of continuous advice and technical support at household level on the availability of latrine are recommended.</span>
The Empowerment of Integrated Development Post of Non-Communicable Diseases in Efforts to Prevent and Control Non- Communicable Diseases
Authors: Yandrizal Yandrizal , Machmud Rizanda , Noer Melinda , Hardisman Hardisman , Afrizal Afrizal , Lipoeto Nur Indrawati , Rahajeng Ekowati , Pramudho P.A Kodrat 
Published: November 2019

Non-Communicable disease has already been the main cause of death in many countries, as many as 57 million death in the world in 2008, 36 million (63 percent) is because of un-infectious disease, specifically heart illness, diabetes, cancer, and chronic respiratory diseases. Prevention and controlling efforts of un-infectious diseases developing in Indonesia is non-communicable disease integrated development post (Pospindu PTM). This research used combination method approach with exploratory design. Exploratory design with sequential procedure used combination consecutively, the first is qualitative and the second is quantitative method. Public Health Center formed Posbindu PTM has not disseminate yet to all stakeholders. Posbindu PTM members felt benefit by following this activity. Some of them did not know follow the activity because of unknown about it. There was connection between coming behavior to Posbindu PTM to preventing behavior of non-communicable disease.Percentage for high blood pressure risk indicated 20-25 percent from all visitors. Formulation of its policy implementation started with stakeholder analysis; head of sub district, head of urban village, head of health department in regency/city, head of public health service, head of neighborhood Association, and the head of family welfare development. Analysis of perception, power and authority found that every stakeholder had authority to manage the member directly or indirectly. It was not implemented because of the lack knowledge of stakeholders about the Posbindu PTM function.They would play a role after knowing the aim and advantage of the post by motivate the people to do early detection, prevention and control the non-communicable disease. The members were given wide knowledge about early detection, preventing and control the un-infectious disease, measuring and checking up their healthy continuously so that keep feeling the advantage of coming to the post.
Deep Breathing Relaxation Techniques Improve Emotional Control on Tuberculosis Patients
Authors: Namuwali Domianus , Mendrofa Fery Agusman , Dwidiyanti Meidiana 
Published: November 2019

Tuberculosis is an infectious disease caused by Tuberculosis Mycobacterium. Based on WHO report in 2014, the world population suffering from tuberculosis were 9.6 million people while in Indonesia it was amounted 324 539 people. Tuberculosis patients have a tendency to experience emotional disturbance due to the illness. A deep breathing relaxation is a nursing action for controlling emotions of tuberculosis patients. The study design is quasi-experimental design with one group pre-test-post-test. Data were collected by using a questionnaire adapted from Gross and John (2003). Data were analyzed using paired t test. The results of this research is deep breathing relaxation technique is effective to control emotions of tuberculosis patients with p value = 0,001.
The Formulation of High-Calorie and Rich-Fe Biscuits for Pregnant Women with Chronic Energy Malnutrition
Authors: Sunarti Sunarti , Hanim Diffah , Ahda Mustofa , Mudayana Ahid , Kusnandar Kusnandar 
Published: November 2019

Supplementary food distribution for pregnant women still depends on the local policy. This program is funded using Health Operational Funds and distributed in form of milk, eggs, raw materials such as green beans and others. The field constraints of this program were acceptability and willingness of pregnant women to process the raw materials. This study aims to address the problems of providing supplementary food for pregnant women who suffer from chronic energy malnutrition and anemia by making the formulation of high protein biscuits and Fe using soybean flour substitution catfish eggs and flour as a source of protein and Fe. Biscuits produced is expected to be one of the snacks and nutritions for women who suffer from chronic energy deficeincy. The ingredients were flour, fish powder, soy flour, eggs, milk powder, sugar, and maize flour. The method used was pure experimental approach completely randomized design with three times repetition. The formulation of the biscuits proportion between fish and soy flour as much as 2:1, 1:1, and 1:2. Proximate test shows that the proportion of fish and soy flour 1:2 has the highest energy value (496.81 kcal) with a value of 17.74% protein. Organoleptic test indicates that the most favorable taste and tekstur was the formulation with the proportion of fish flour and soy flour 1:2. The formulation of high protein and Fe biscuits for women with chronic energy malnutrition and anemia in Boyolali favoured by third trisemester pregnant women is the one with the proportion of 1:2.
Knowledge and Attitude of Students on Antimicrobial Resistance at Debre Markos University, Ethiopia
Authors: Zelellw Desalegne Amare , Bizuayehu Habtamu Mellie 
Published: November 2019

Irrational use of medicines is a key reason for the increase and spread of antimicrobial resistance and it is a global concern. It is a fast mounting universal crisis. The main of this study of this study was to assess knowledge, attitude and practice of university students on antimicrobial resistance at Debre Markos University. Institutional based comparative cross-sectional survey was conducted from June to July with total sample size of 670. Participants were selected using simple random sampling method using random number table. Data clerk double entered the data into Epi data version 3.1 and transferred to SPSS Windows software version 21.0. Those variables that had associations at binary stage with p-value &lt; 0.1, not collinear and biologically important variables were entered in to multiple logistic regression models. The cut off point for association was p-value &lt; 0.05.<strong> </strong>About 14.8% study participants had adequate knowledge towards drug resistance. Rural residences of the participants were significantly associated with drug resistance as compared to urban residence. Knowledgeable participants were significantly protective to self- medication and drug resistance as compare to those who had inadequate knowledge and participants who had positive attitude were positively associated with self-medication as compare to those who had negative attitude. The overall knowledge of participants regarding to antimicrobial resistance was low. In the other hand, majority of participants had positive attitude. Those participants who had positive attitude were significantly associated with antimicrobial resistance as compared to who had negative attitude.
Availability of Adequately Iodized Salt at Household Level and Associated Factors in Dire Dawa, Eastern Ethiopia
Authors: Yaye Anteneh Berhane , Baraki Negga , Endale Birhanu Seyum 
Published: November 2019

In Ethiopia, Iodine Deficiency Disorder has been recognized as a serious public health problem for the past six decades. In 2011, an estimated 12 million school-age children were living with inadequate iodine, and 66 million people were at risk of iodine deficiency. One out of every 1000 people is a cretin mentally handicapped, due to a congenital thyroid deficiency, and about 50000 prenatal deaths are occurring annually due to iodine deficiency disorders. Only 5.7% of the households were using iodized salt in Dire Dawa city Administration, which is below the legal requirement.This study assessed availability of adequately iodized salt at household level and associated factors in Dire Dawa town, East Ethiopia. Community based cross-sectional study was carried out among households in Dire Dawa town during March 16-26, 2015. Multistage sampling technique was used. Data were collected using a pretested and structured questionnaire by a face-to-face interview technique. Bivariate and multivariate analyses were performed to check associations and control confounding. A total of 694 participants were participated. The availability of adequately iodized salt (≥15 parts per million) in the study area was 7.5% (95% CI; 5.6-9.5). Multivariate result showed that health information about iodized salt (AOR=8.96, 95% CI; 4.68-17.16) (p=0.03), good knowledge about iodized salt (AOR=9.23, 95% CI; 3.34-25.5) (p=0.01) and using packed salt (AOR=3.99, 95% CI; 1.48-10.73) (p=0.006) were associated with availability of adequately iodized salt at household level. Availability of adequately iodized salt at household level was very low. Hence, households should be sensitized about importance of iodized salt and its proper handling at the household level.
Association of Physical Activity with Co-morbid Conditions in Geriatric Population
Authors: Hisam Aliya , Rahman Mahmood Ur , Khan Rimsha , Ilyas Sundus , Jabbar Anosha , Kazmi Syed Awais , Mushtaq Umer 
Published: November 2019

To find out association of physical activity with co-morbid conditions in geriatric population, a cross-sectional study was conducted in different cties of Pakistan in 2015. A total of 114 participants were inducted by non-probability convenience sampling technique. Data was collected after informed verbal consent by a validated questionnaire that is Rapid Assessment of Physical Activity (RAPA). Participants were categorized into two groups i.e. physically active and physically inactive. Data was entered and analyzed in SPSS version 20. There were 66 (57.9%) males and 48 (42.1%) females with mean age of 57.04±7.348 years. Among hypertensive individuals (n=43, 37.7%) there were 39 (90.7%) physically inactive, among individuals having angina (n=17, 14.9%) there were 15 (88.2%) physically inactive. Out of 37 (32.5%) diabetics, 35 (94.6%) were physically inactive. Among individuals suffering from arthritis (n=40, 35.1%), there were 38 (95%) physically inactive. A significant association was found between physical activity and diabetes and arthritis with p-value of 0.048 and 0.029 respectively. Physical activity is significantly associated with diabetes and arthritis in geriatric population. Adequate physical activity should be performed to reduce the risk of co-morbid conditions and improve the quality of life in geriatric population.
Ethnicity, Obesity, and Type 2 Diabetes of Adults in Urban Populations of Central America
Authors: Wuenstel William G , Johnson James A. , Humphries James , Samuel Cheryl 
Published: November 2019

The purpose of this meta-analysis was to examine the impact of ethnicity and obesity as it relates to Type-2 Diabetes (T2D) in specific Central American countries. A meta-analysis was conducted to determine the association of ethnicity, obesity, and T2D. Four studies that qualified for inclusion were identified by searching MEDLINE and PubMed databases. The studies on the association of ethnicity and T2D had a combined population resulted in 265,858 study participants. Two studies on the association of obesity and T2D had 197,899 participants. An analysis of the data was conducted utilizing the relative risk ration, odds ratio, and forest plots. The comparison of the relative risk of T2D across ethnic categories by studies range for Blacks was 1.59 to 2.74, Asians was 1.43 to 2.08, and Hispanics .92 to 2.91. The ethnic difference in the prevalence of diabetes was almost two-fold higher in all ethnic groups than among the Caucasians with a significance level of 95%. A comparison of relative risk of T2D across weight categories was significantly higher among those with a diagnosed of diabetes in all reported areas. The odds ratio was very close to the risk ratio in both ethnicity and obesity to the development of T2D.The meta-analysis findings documented that an association does exist between ethnicity and obesity to the development of type 2 diabetes.
Hippocampal Brain Derived Neurothropic Factor Levels in Response to Anaerobic Physical Exercises
Authors: Zulkarnain Mohammad , Flora Rostika , Juliastuti Juliastuti , Apriany Anita , Pujiana Dewi , Andrianti Septi 
Published: November 2019

Anaerobic physical exercise does not only improve body fitness, but it also increases cognitive functions. The increase of cognitive functions is mediated by the increase of Brain Derived Neurothropic Factor (BDNF) level. Several studies revealed that anaerobic physical exercise can increase the BDNF level inhippocampal tissues. However, it is still questionable whether or notthe frequency of exercise influences the production of BDNF inhippocampal tissues. This study was to find out the BDNF mean level inhippocampal tissue of Wistarrats which were treated with anaerobic physical exercises conducted in different frequencies.This study used post test only control groupdesign. The research subject was 28 rats of Rattusnorvegicus strain wistar divided into 4 groups; 1 control group and 3 treatment groups (one-time, three-time, and five times a week treatment). The anaerobic physical exercise used animal treadmill running in the speed of 35m/min for 20 minutes at four-minute intervals. The mean levels of BDNF were increased in all treatment groups compared with control group (151.588 vs 57.059). The highest mean level of hippocampal tissue BDNF was found in the treatment group of three times a week (177.701). There was a significant difference in BDNF mean levels of Wistar rat brain tissues among the treatment groups.
Age, parity and birth spacing to the incidence of preeclampsia
Authors: Kartikadewi Reza , Theresia Endah Marianingsih , Meilani Niken 
Published: November 2019

Preeklampsia is complication in pregnancy characterized by various symptoms as clinical hypertension and protein urine and usually occurs after the age of 20 weeks of pregnancy until 48 hours after labor. Highest Insidence of preeclampsia in DIY was in Sleman (22%- 30%). Preeclampsia was caused by multy factoral. Goal of this research aimed to know the the correlation between age, parity and birth spacing to the preeclampsia. The research used Cross sectional design with purposive sampling technique. The subject of this research was 381 labor patiens in RSUD Sleman in 2016. The data were collected from register book and medic record of labor in 2016. <em>The data were analyzed using Chi square</em>and logistic regression. The analysis showed of most subjects aged ≥30 years, had parity 2, had a gestational distance of 2-5, and did not have preeclampsia.As the result showed age ≥30 years had a significant association with preeclampsia <em>p value</em> of 0.023 Exp B 10.630 95% CI: 1.378 to 82.005. Distance pregnancy &lt;2 years had a significant association with preeclampsia <em>p value </em>0,000 <em> Exp</em> B 3,201 95% CI: 1.862 to 5.503, and the distance Pregnancy &gt;5 years had a <em>p-value</em> 0.013 with Exp B 3,622 95% CI: 1.308 to 10.026.The conclusion of this research shows that there is a relationship between age and the incidence of preeclampsia pregnancy spacing.
Integrating palliative care and hospice services in long term care: an eightfold path health policy analysis
Authors: Tan Amil Kusain 
Published: November 2019

It is evident in the literature that as near end of life approaches, health expenditure increases. The rehospitalization and underutilization of palliative and hospice services add to the burgeoning health cost. There is a lack of support for patients with advanced illness in long-term care facilities. This paper aims to provide a comprehensive review of the problem and assess alternatives to reduce readmission among patients with advanced disease and those who are at the end of life. This paper adapted Bardach’s Eightfold Path analysis as a guide to analyzing the problem using a case study approach. The article discussed the issues, reviewed the literature for evidence, provided the alternatives, identified criteria, evaluated projected outcomes, discussed the trade-offs of adopting the policy, and provided a recommendation. In conclusion, integration of palliative and hospice care services across the continuum of long-term care is a viable alternative policy to address the problem.
A New Satellite-Based Global Climatology of Dust Aerosol Optical Depth
Authors: Voss Kara K. , Evan Amato T. 
Published: November 2019

AbstractBy mass, dust is the largest contributor to global aerosol burden, yet long-term observational records of dust, particularly over the ocean, are limited. Here, two nearly global observational datasets of dust aerosol optical depthτdare created primarily on the basis of optical measurements of the aerosol column from 1) the Moderate Resolution Imaging Spectroradiometer (MODIS) aboard theTerrasatellite spanning from 2001 to 2018 and 2) the Advanced Very High Resolution Radiometer (AVHRR) from 1981 to 2018. The quality of the new data is assessed by comparison with existing dust datasets that are spatially more limited. Between 2001 and 2018,τddecreased over Asia and increased significantly over the Sahara, Middle East, and parts of eastern Europe, with the largest increase found over the Aral Sea where emissive playa surfaces have been exposed. These daily, observational, and nearly global records of dust will allow for improvement in understanding the role of dust in climate variability.