bluuebunny/crossref_metadata_2025_split huggingface dataset:
Barreras de acceso a los servicios primarios de salud sexual y reproductiva en adolescentes, de una comunidad urbano marginal del Perú
Authors: Ypanaque Ancajima Jhon Edwin 
Published: January 2024

Introducción: Las barreras de acceso a los servicios de salud primario conforman estructuras sociales que agravan la situación de salud de los adolescentes, impactando negativamente en el ejercicio pleno de la salud sexual reproductiva, situando a los adolescentes en una población de riesgo social. Objetivo: Determinar las barreras en el acceso a los servicios primarios de Salud Sexual y Reproductiva de atención diferenciada a los adolescentes del Centro de Salud I – 4 Pampa Grande Tumbes 2018. Metodología: Estudio analítico de caso control, se entrevistaron a 288 adolescentes del tercero, cuarto y quinto de secundaria de la institución educativa pública Túpac Amaru del centro poblado Pampa Grande de Tumbes en el año 2019, entre experimento y control con una razón de 1 a 1. Se aplicaron cuestionarios anónimos para evaluar las barreras de accesibilidad a los servicios primarios de salud. Se recogieron variables: características sociodemográficas y culturales que son consideradas, como barreras de acceso a los servicios de salud. Se realizó un análisis descriptivo e inferencial con el programa SPSS® v.23. Resultados: La edad, sexo e ingreso económico están directa y significativamente relacionadas con la accesibilidad a los servicios de salud sexual y reproductiva (p<0.01 IC 95 %); La disposición de recursos económicos para asumir los costos de traslado al centro de salud (OR = 4,23); la utilización del transporte público (OR = 1,58), el conocimiento de los servicios de salud sexual y reproductiva (OR = 1,15) incrementan la probabilidad de acceder a los servicios de salud sexual y reproductiva de los adolescentes. Discusión: Las barreras socioeconómicas a los servicios de salud sexual y reproductiva de los adolescentes son modificables y dependen de la gestión en salud pública.
Baja disponibilidad de recursos y apoyo para atender a personas con diabetes e hipertensión arterial en las Unidades de Salud de la Familia de Paraguay
Authors: Giménez Caballero Edgar , Amarilla María Gloria , Araújo Quevedo José Modesto 
Published: January 2024

Introducción: Paraguay asumió el reto de lograr cobertura universal mediante redes basadas en Atención Primaria de la Salud con Unidades de Salud de la Familia (USF) en el primer nivel de atención. Un desafío es la atención integral ante enfermedades no transmisibles, principal causa de mortalidad en el país. Objetivo: analizar la capacidad de las USF para la atención de personas con hipertensión arterial y diabetes en el sistema nacional de salud. El diseño fue no experimental, cuantitativo, transversal, descriptivo con componente analítico. Metodología: Incluyó a 761 USF de 12 regiones sanitarias agrupados en 4 ejes territoriales. Se adaptó el método de evaluación SARA de la OMS con 75 variables, aplicando un cuestionario a profesionales de salud entre noviembre y diciembre de 2022. Se calculó índices de disponibilidad y preparación así como un índice que los integra. La medida continua de estos índices se categorizó en 3 grupos: suficiente >0,75 a 1; intermedio 0,5 a 0,75 y bajo <0,5. Resultados: Solo en el 38 % de las USF el índice de disponibilidad fue suficiente, en el 31,5 % para el índice de preparación y en el 31,1 % para el índice integrador SARA DM/HTA. El desempeño se asoció de forma significativa con el eje territorial no así con el área ni con la cobertura a población indígena Discusión: las USF presentaron limitaciones para la atención de personas con diabetes e hipertensión en estas regiones del país.
Sürdürülebilir Kalkınma Amaçlarına Ulaşılmasında Çevre Denetimlerinin Rolü
Authors: DİKMEN Süleyman 
Published: January 2024

Sürdürülebilir Kalkınma Amaçları (SKA’lar), dünyanın karşı karşıya kaldığı çevresel, ekonomik ve sosyal sorunlarla mücadele edilmesine yardımcı olmak üzere Birleşmiş Milletler (BM) tarafından 2015 yılında kabul edilen amaç ve hedeflerden oluşmaktadır. Yüksek denetim kurumları (YDK’lar), sürdürülebilir kalkınma için etkili, hesap verebilir, şeffaf, etkin ve kapsayıcı kurumların merkezinde yer almakta olup bireysel yetki ve görevleri çerçevesinde SKA’ları takip eder ve gözden geçirirler. Sürdürülebilir kalkınmanın
öneminin artması ile YDK’lar, çevreye ve çevre politikasına karşı rol ve sorumluluklarının farkına varmış ve çevre denetimi, YDK’ların denetim faaliyetlerinin önemli bir parçası haline dönüşmüştür. Çalışma YDK’ların çevre denetimini SKA’lar çerçevesinde ele almayı amaçlamakta olup çevre denetiminin SKA’lara nasıl katkıda bulunabileceğini incelemektedir. Bu kapsamda sürdürülebilir kalkınma ve YDK’lar arasındaki ilişkiye ilişkin literatürden, Çevre Denetimi Çalışma Grubu (Working Group of Environmental Auditing - WGEA) tarafından yayımlanan anket bulgularından ve YDK’ların denetim raporlarından yararlanarak konuya ilişkin yeni değerlendirmelerde bulunulmuştur. Çalışmada çevre denetiminin SKA’lara ulaşılmasına olumlu katkı yapabileceği, YDK’ların gözetim işlevlerini kullanarak SKA’ların uygulanması konusunda mali kaynakların etkin, etkili ve şeffaf harcanmasını teşvik edebileceği ve bu anlamda hükümetleri sorumlu tutabileceği ve
bağımsız bilgiler sağlayabileceği belirlenmiştir.
How do the revised National Accounts affect the interpretation of how the Spanish economy has fared since the pandemic?
Authors: Fernández José Luis , González Mínguez José , Izquierdo Mario , Urtasun Alberto 
Published: January 2024

Rationale
The revision to the Annual and Quarterly National Accounts figures by the National Statistics Institute in September was more extensive than in previous years and has altered the interpretation of some aspects of Spanish economic developments since the pandemic.
Takeaways
•The new figures entail upward revisions to GDP of 0.2 percentage points (pp) in 2020, 0.9 pp in 2021 and 0.3 pp in 2022. The Spanish economy therefore recovered its pre-pandemic level in 2022 Q3 (rather than in spring 2023, as per the previous information), one year later than the euro area overall. The main factors underlying these revisions are, on the demand side, the greater domestic demand momentum and, on the supply side, the greater strength of services.
•The new time series signal that productivity has fared somewhat better, tax revenues have been more consistent with macroeconomic developments, household expenditure has been more dynamic, in keeping with the improvement in real labour income, and unit labour costs have increased more than previously estimated, rising in Spain more than in the euro area overall since 2019, which could ultimately impact Spanish firms’ competitiveness.
Determinants of unmet needs for family planning in Indonesia: Secondary data analysis of the 2017 Indonesia Demographic and Health Survey
Authors: Sumiati Luh Nyoman , Wirawan Dewa Nyoman , Ani Luh Seri 
Published: January 2024

Background and purpose: Globally, the unmet need for family planning remains high. The proportion of unmet needs for family planning in Indonesia was found to have declined but was still higher than the set target. In the last 5 years there have been significant development in Indonesia including infrastructure, the national health insurance program and the increasing allocation of funds to all villages throughout Indonesia with a possible impact in decreasing the unmet need for family planning. This study aims to determine the factors associated with unmet needs for family planning in Indonesia.
Methods: This study uses secondary data from the 2017 Indonesia Demographic and Health Survey (IDHS) that was carried out in 34 provinces in Indonesia. The number of the analyzed samples was 26,479 of the total 2017 IDHS sample of 35,681 married women/living together with their partner aged between 15-49 years. The dependent variable is the unmet need for family planning, while the independent variables consist of four core variables namely individual, household, community and programmatic variables. Data analysis was performed with a binary logistic regression to obtain the adjusted odd ratio of each factor.
Results: The proportion of unmet needs in this analysis was 14.3% (95%CI: 13.9-14.7%). Factors associated with unmet needs are maternal age 25-34 years (AOR=1.17; 95%CI: 1.01-1.36), 35-44 years (AOR=1.47; 95%CI: 1.24-1.74), ≥45 years (AOR=2.20; 95%CI: 1.81-2.68), age of last child ≥10 years (AOR=1.30; 95%CI: 1.16-1.45), number of living children <2 (AOR=1.66; 95%CI: 1.49-1.85), ideal number of children >2 (AOR=1.34; 95%CI: 1.24-1.44), have >1 son (AOR=1.12; 95% CI: 1.00-1.25), husband not working (AOR=1.89; 95%CI: 1.44-2.48), lack of knowledge about family planning methods (AOR=1.42; 95%CI: 1.24-1.63), not discussing family planning with partners (AOR=1.12; 95%CI: 1.03-1.21), living in urban area (AOR=1.24; 95%CI: 1.14-1.34) and regions with TFR >2.4 (AOR=1.59; 95%CI: 1.43-1.78).
Conclusion: The proportion of unmet needs in Indonesia is still high and the dominant associated factor is the age of the mother ≥45 years. In order to decrease the family planning unmet needs, the intervention programs should be targeted to groups of women who are at risk of experiencing such unmet needs.
Exercise behaviour and the determinant factors among medical students before and during the COVID-19 pandemic
Authors: Griadhi Adiartha , Sundari Luh Putu Ratna , Sutarsa I Nyoman 
Published: January 2024

Background and purpose: Students’ physical activity levels decreased significantly after college enrollment. Disruption during the COVID-19 pandemic also affects the students’ exercise level. The psychological aspect and the academic situation of medical students could interact with pandemic disruption differently compared to other students. This study compares exercise behaviour and its determinant factors among medical students before and during the pandemic.
Methods: This study was conducted by collecting data in August 2021 and then comparing it to our data collected in July 2011. Participants were determined by a proportional random sampling based on gender and education year. There were 127 and 205 research participants in 2011 and 2021. The exercise behaviour and determinant factors were based on the Transtheory Model of behavioural change and grouped into five stages of exercise levels and four categories of factors. The data were analyzed descriptively and comparison tested for the two years.
Results: This study showed a significant increase in exercise behaviour among medical students during the pandemic (p<0.05). The number of students in the pre-contemplation, contemplation, and preparation stages has decreased, and those in action and maintenance stages doubled compared to the pre-pandemic period. The change in exercise behaviour showed that changes only occurred in female and clinical-year students (p<0.05). There was no significant change in male and pre-clinical medical students. Predisposing, enabling, and maintenance factors are determinants of exercise behaviour that increased significantly during the pandemic (p<0.05), and personal factors did not increase significantly.
Conclusion: Female and clinical-year medical students’ exercise activity increased significantly during the pandemic. Predisposing, enabling, and maintenance factors also increased substantially during the pandemic, while personal factors did not change significantly. Gender-related psychological and behavioural reactions to COVID-19 pandemic disruption explain these results.
Association between Body Mass Index and Vitamin D Serum in Asian Population: A Systematic Review
Authors: Suhartono Janice , Astiarani Yunisa , Regina  
Published: January 2024

than other populations with the same body mass index (BMI). Fat accumulation is suspected of mediating the rise and fall of Vitamin D levels linked to BMI. However, the results of studies assessing the association between BMI and Vitamin D serum in Asian population still varied. This study is conducted to determine the association between BMI and vitamin D serum in the Asian population.
Methods: This study was conducted with a systematic review method to identify scientific articles reporting the association between BMI and Vitamin D serum in the Asian population. The data collected for this systematic review were from 5,477 studies filtered with the inclusion and exclusion criteria, resulting in eleven studies presenting 7,496 respondents.
Results: Nine studies concluded an association between increasing BMI from the normal range and decreasing Vitamin D serum (p<0,05). One study has concluded an association between decreasing BMI from the normal range and decreasing Vitamin D serum (p<0,05). Another has concluded there is no association between BMI and Vitamin D serum (p>0,05).
Conclusion:This systematic review study concludes an association between increasing and decreasing BMI with decreasing Vitamin D serum in the Asian population. Further study using clinical trial in obese people and control to compare the metabolism of Vitamin D should be conducted.
Relationship between cesarean section and early initiation of breastfeeding in Indonesia
Authors: Gayatri Maria 
Published: January 2024

Background and purpose: Breastfeeding initiation is internationally recommended due to its benefits on maternal and child health. The study aims to determine the relationship between mode of delivery and early breastfeeding initiation among women who delivered in health facilities.
Methods: The study was based on The Indonesia Demographic and Health Survey 2017. There were 5,369 women whose children were born in the last 24 months preceding the survey in health facilities in Indonesia. Descriptive statistics and binary logistic regression were used for data analysis. The complex sample design was performed for analyses.
Results: Of the women who had given birth to at least 24 months preceding the survey in health facilities, 57 percent of women were found to practice breastfeeding initiation. The likelihood of breastfeeding initiation among women who delivered in health facilities was associated with mode of delivery, which women with cesarean delivery (OR=0.33; 95%CI: 0.29-0.38) were less likely to practice breastfeeding initiation compared with those with normal vaginal delivery after adjusted by socio-economic factors. Moreover, women aged 35-49 years and non-working women were found to have higher probabilities to practice breastfeeding initiation.
Conclusion: Maternal age, working status, and type of delivery were significantly influencing the practice of early initiation of breastfeeding among women who delivered in health facilities. Policy and intervention to encourage and support early initiation of breastfeeding should be taken into consideration by public health professionals and health providers. Comprehensive breastfeeding counseling should be a part of health care training to encourage moms to start nursing as soon as possible, especially for mothers who have caesarean deliveries. It is important to ensure the implementation of breastfeeding policy on the company’s worksite support policy.
Determinants of the intention to use National Insurance Mobile Application in Badung District based on Technology Acceptance Model Framework
Authors: Indrayathi Putu Ayu , Megayanti Ni Luh Komang , Ulandari Luh Putu Sinthya , Kolozsvari Laszlo Robert 
Published: January 2024

Background and purpose: National Insurance Mobile Application (JKN Mobile) developed by Health Insurance Institution (BPJS Kesehatan) to facilitate the administrative activities of the National Health Insurance (JKN) participants. However, in practice, it has yet to be widely used by JKN participants. This study aims to explore factors determine participants' intention to use the JKN Mobile application based on the Technology Acceptance Model (TAM) Framework.
Methods: This cross-sectional study was conducted in April-May 2021. The minimum required sample size was 99. Inclusion criteria were people 18 years of age or older, residing in Badung District, Bali Province and at least having used the JKN Mobile once. Data were collected through a self-administered questionnaire. A multivariable analysis was then conducted to determine the factors of intention to use the JKN Mobile application.
Results: The proportion of JKN participants interested in using the JKN Mobile was 50%. Perceived usefulness, ease of use, credibility, and amount of information were correlated with the intention to use the JKN Mobile. The linear regression analysis showed that perceived usefulness is significantly associated with the intention to use JKN Mobile (aOR=9.68; 95%CI: 3.33-28.14; p=0.001).
Conclusion: Participants' acceptability to use JKN Mobile is associated with the benefits of using such an application. It is thus imperative for BPJS Kesehatan to simultaneously update the design and features to be readily accepted and used by the public, which will later affect interest in using the application.
Teachers’ perception on COVID-19 vaccination and preventive behaviour in Denpasar, Bali
Authors: Sridyantari Luh Verra , Sawitri Anak Agung Sagung , Putra I Wayan Artawan Eka 
Published: January 2024

Background and purpose: Teachers as one of the public service providers are at risk of transmitting or contracting COVID-19, so they are prioritized to get COVID-19 vaccination. This study aims to explore teachers’ willingness to vaccinate, their behaviour and perception after COVID-19 vaccination.
Methods: We conducted a cross-sectional study involving 200 teachers from 20 primary and secondary schools in Denpasar, who were selected by stratified multistage random sampling. The variables collected are sociodemographic characteristics (age, gender, religion, education, economic status), willingness to be vaccinated, behaviour after the vaccination, and the beliefs which include perceived vulnerability, perceived seriousness, and perceived benefits. Data analysis was carried out descriptively to describe the behaviour and perception of teachers after the vaccination.
Results: Most teachers were middle-aged (31-45 years) and female (74%), with undergraduate education (84%). Most of the respondents were willing to be vaccinated and had been vaccinated (97%). Respondents had a low vulnerability belief of 18%, a high seriousness belief of 8.5% and a low benefit belief of 3.5%. All teachers have intentions to continue implementing health protocols to prevent transmission of COVID-19.
Conclusion: Some school teachers have low perceived vulnerability, high seriousness, and belief of low benefits after vaccination. This shows that teachers are still unsure about the COVID-19 vaccine effectiveness in preventing the transmission of COVID-19, so further education effort is needed.
Ocular Manifestations in People Living with HIV/AIDS (PLWHA) at the Kerti Praja Foundation, Denpasar, Bali
Authors: Triningrat A A Mas Putrawati , Handayani Ariesanti Tri , Juliari I Gusti Ayu Made , Utari Ni Made Laksmi , Ratnasari Ni Luh Made Novi 
Published: January 2024

Background and purpose: People living with Human Immunodeficiency Virus - acquired immunodeficiency syndrome (PLWHA) could present various ocular manifestations according to the CD4+ lymphocyte count. This study aims to determine the socio-demographic characteristics and ocular manifestations of PLWHA.
Methods: This study is an observational study with a cross-sectional design and consecutive sampling, involving a total of 118 samples, conducted in August 2021 at Kerti Praja Foundation Denpasar. Data were collected through history taking and ocular examinations, which included the variables of gender, age, occupation, residence, working status, level of education, duration of ARV treatment, treatment compliance, visual acuity, anterior segment manifestation, posterior segment manifestation, and CD4 T-cell count. Data analysis was performed with a statistical software.
Results: A total of 118 samples were involved in this study, with 53 respondents (44.9%) experienced ocular manifestations and 55.1% did not experience ocular manifestations. The most frequent ocular manifestation identified was dry eye (68.5% found in right eye and 54.9% found in left eye), while only 2 patients have posterior-segment manifestation.
Conclusion: The most common ocular manifestation in HIV-infected people on anti-retroviral therapy was dry eye. Screening for dry eye is recommended in PLWHA.
Intention to use telemedicine based on the Unified Theory of Acceptance and Use of Technology Model
Authors: Indrayathi Ayu , Julyari Dewa Ayu Vera , Pradnyani Putu Erma , Luh Putu Sinthya Ulandari  , Soukaina Hilal  
Published: January 2024

Background and purpose: Due to COVID-19 pandemic, demand for technology in daily interaction has rapidly grown to ease communication while maintaining physical distance. This study examines the determinants of the intention to use telemedicine using the Unified Theory of Acceptance and Use of Technology (UTAUT) Model.
Methods: This cross-sectional study was an online survey using Google Form application conducted from March 11 to May 3, 2021. The inclusion criteria of samples were aged 18 years or older, residing in Bali during the data collection period and knowing telemedicine health services. Variables collected include intention to use telemedicine, demographic characteristics of respondents and UTAUT variables, namely performance expectancy, business expectancy, social influences, and facilitation conditions. The statistical test used is simple and multiple logistic regression analysis.
Results: Of 458 survey respondents, 287 were included for analysis due to incomplete data. Almost half of the respondents (48.8%) was aged <25 years old, the majority were female (80.51%) and around two-thirds, were studying in university, being employed and earning income. We found most respondents (57.14%) were highly interested in telemedicine services. The logistic regression analysis showed that performance expectations, business expectations, social influence, and facilitating conditions were significantly associated with people's interest in telemedicine in Bali.
Conclusion: Telemedicine is relatively popular in Bali, Indonesia. Performance expectancy, effort expectancy, and social influence are the predominant factors influencing the intention to use telemedicine. It shows the potential to employ telemedicine service to cover the inadequate distribution of health professionals and healthcare in Indonesia.