United States have also appeared similar cases. ...... were identified by searching the reference lists of the full text articles and performing a citation search.
1-1-O Factors Associated with Turnover Intention among Professional
Women in Science and Technology: A Study of Work-Family Role Conflict.
Anthonia Ginika Uzoigwe 1, Wah Yun Low 2, Siti Nurani Noor 1 Department of Science and Technology studies, faculty of Science, University of Malaya., 2 Research Management Centre, Faculty of Medicine, University of Malaya.
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Objectives: Antecedents of work-family related stressors, are usually examined in terms of tension, anxiety, fatigue, depression, irritability, and burnout, hence, creating negative effects on the physical and mental health of employees. This study examined factors associated with turnover intention among female professionals across three fields: engineering, Information Technology (IT) and medicine. Methods: Data was obtained from 173 professional women in 20 engineering and IT firms and one public and one private hospital in Lagos State Nigeria. Work-family role conflict was measured using 5 items on seven points Likert scale 1=strongly disagree to 7=strongly agree (Netemeyer, Boles and McMurrian 1996). Score ranged from 5 to 35, where the higher the score, the higher work-family role conflict experienced. Turnover intention was measured using 5 items on five points Likert scale 1=strongly disagree to 5=strongly agree, (Karatepe and Sokmen 2006). score ranged from 5 to 25. The higher the score, the higher the intention to quit. Findings: The findings indicated that work-family role conflict is experienced across the three fields of Engineering (45%), IT (25%) and Medicine (30%). Family-responsibilities, job demand, work role overload and work-family role conflict were significantly and positively correlated with turnover intention (63%), all P 1.96, P < 0. 05) in 20142015. Local spatial autocorrelation showed that in 2014 there were four High-High (HH) clusters mainly distributed in Dawu County, Hong'an County, Yingshan County and Xishui County; in 2015 there were five High-High (HH) clusters mainly distributed in Yingshan County, Xishui County, Luotian County, Tuanfeng county and Huangpi District. Conclusion: The incidence of SFTS in Hubei Province was on the rise, the most vulnerable groups were elders and the farmers, and the onset season was concentrated in summer. The disease had a positive spatial autocorrelation and exhibited aggregation distribution. The HH clusters were mainly concentrated in the northeast of Hubei Province, and had a tendency to spread to the southeast.
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4-3-O Peroxisome proliferator-activated receptor (PPAR)γ and PPARδ
function in Mycobacterium leprae -induced foam cell formation in host macrophages
Yuqian Luo 1,2, Kohei Ishikawa 1, Kenzaburo Oda 1,2, Aya Yoshihara 1,2, Kensei Usukura 1, Kengo Sekihata 1, Mika Yoshizato 1, Kazunari Tanigawa 2,3, Yuko Ishido 1,2, Koichi Suzuki 1,2 1 Department of Clinical Laboratory Science, Faculty of Medical Technology, Teikyo University, 2 Laboratory of Molecular Diagnostics, Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, 3 Department of Molecular Pharmaceutics, Faculty of Pharma-Science, Teikyo University
Objectives and Methods: We previously reported that Mycobacterium leprae (M. leprae) induces a lipid-rich intracellular environment that is favorable to their parasitization in macrophages via modulating host gene expressions related to lipid droplet formation. In order to obtain a detailed picture of M. leprae-host interaction, a comprehensive transcriptional profiling of M. leprae-infected human macrophage THP-1 cells was performed using Agilent Whole Human Genome Oligo DNA Microarray analysis. Non-infected cells and cells exposed to heat-killed M. leprae were included as controls. Results: Cluster analysis of the DNA microarray data revealed that host transcriptional landscape was profoundly and specifically reshaped by M. leprae infection. In particular, a cluster of peroxisome proliferator-activated receptors (PPARs) target genes that are associated with intracellular lipid accumulation were remarkably induced by M. leprae infection. Among the three members of PPAR gene family, the expressions of PPARγ and PPARδ, but not PPARα, were significantly induced by M. leprae infection, as evaluated using real-time PCR and Western blot analysis. Moreover, nuclear accumulations of PPARγ and PPARδ were increased in M. leprae-infected THP-1 cells as demonstrated by immunofluorescence staining, indicating that M. leprae infection stimulates PPARγ and PPARδ activities in host cells. The antagonist of PPARγ or PPARδ abolished the effect of M. leprae to modulate host adipose differentiation-related protein expression, and inhibited lipid droplet formation in M. leprae-infected host cells. Conclusion: These results suggest that PPARγ and PPARδ function in M. leprae-induced foam cell formation in host macrophages, and provide insight to novel therapeutic targets and modalities for treating M. leprae infection.
4-4-O Evaluation of Clinical and immune status of HIV positive cases and
negative controls using Flow-Cytometry technology in Fiji.
Santha Muller 1, Atlesh Nand Sudhakar 1, Dashika Balak 2, Morgan Downes 1 Medical Research Laboratory, 2 Ministry of Health and Medical Services
1
CD4+ T-cell count through the use of Flow Cytometry technology is considered as a “gold standard” and is a pivotal parameter particularly for the management HIV patients at the various stages of the disease. Fiji is classified as a low prevalent country for HIV with a report of 647 positive cases by December, 2015 since 1989. The essential monitoring tool for HIV disease progression in resource limited settings such as Fiji has now become one of the key challenges especially for the timely initiation of Anti-Retroviral Therapy (ART) to the HIV patients. Medical Research Laboratory (MRL) has initiated a case control cohort study in 2014 by introducing a state -of -art 4 colored Accuri C6 Flow Cytometer to determine the CD markers such as CD8+ and CD45+ cells in addition to CD3/CD4+ T-cell enumerations and percentages compared to negative controls. The results analyzed shows that the mean absolute CD3+/ CD4+ count in HIV seronegative controls and HIV seropositive cases was 752 ± 233 (cells/uL) and 292 ±141 (cells/uL) respectively (P < 0.01). Further, analysis shows that the mean absolute CD8+ count in HIV cases was 582 ± 206 (cells/uL while seronegative controls had the mean absolute CD8+ count of 450 ±187 (cells/uL). The seronegative controls had a mean CD4:CD8 ratio of 1.8 ± 0.8 whereas, the mean CD4+:CD8+ ratio in HIV positive individuals in the Fijian population was lower than 1. Furthermore, it was found out that the CD45+ markers were expressed at high levels in control cells when compared to positive cases. In the present study, a wide variation in the mean CD4+, CD45+ counts, and CD4:CD8 ratio between the HIV positive cases and seronegative controls were observed where cases generally showing the lower count. With the advent of versatile and first of its kind advanced medical tool, Flow Cytometry technology can be used for the monitoring of leukocyte changes as a barometer of disease progression in HIV patients in Fiji. Although alternate technologies have been commercially developed, Flow Cytometry remains the current standard. Therefore, this technology will be unprecedentedly relevant to the Ministry of Health and Medical Services (MOHMS) Fiji considering the improvement of the ART for the HIV patients and facilitation of a positive health information policy in the future. Key words: CD4, CD8, CD45 counts, CD4:CD8 Ratio, Flow Cytometer, Leucocyte, Anti-Retroviral Therapy (ART).
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4-5-O Different distribution of human T-lymphotropic virus type I (HTLV-1)
tax subgroup among Okinawa Islands
Shugo Sakihama 1, Megumi Kuba-Miyara 1, Yukako Kaneshiro 1, Carmina Louise Hugo Guerrero 1, Yukina Shimaru 1, Eiko Ichikawa 2, Mitoko Maekouchi 2, Rieko Uehara 2, Takaki Hashimoto 2, Takuya Fukushima 1 Laboratory of Hematoimmunology, School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Japan, Kariyushi Hospital, Ishigaki Island, Okinawa prefecture, Japan
1 2
Objective The Southwest Japan, Kyushu and Okinawa, is the most endemic area for human T-lymphotropic virus type I (HTLV-1), the etiological retrovirus of adult T-cell leukemia/lymphoma (ATL). It had been reported that HTLV-1 genotype in Japan was classified into taxA and taxB by tax genotyping, and that the taxA to taxB ratio was 1 : 9 in Kagoshima prefecture, located in Kyushu. On the other hand, we previously demonstrated that the taxA to taxB ratio was 4 : 6 in main island of Okinawa, which was quite different from the above. In this study, we investigated the distribution pattern of tax genotype in each of islands of Okinawa. Methods Genomic DNA samples of peripheral blood mononuclear cells from HTLV-1 carriers (HCs) at Kariyushi hospital, located in Ishigaki island, were applied to PCR-RFLP method for tax genotyping. Fisher’s exact test was performed to compare the distributions of tax subgroups in each of birthplaces. Results Tax genotype was identified in a total of 62 samples, including 3 cases without information about birthplace. According to birthplace, the numbers of taxA and taxB were 27 (67.5%) and 13 (32.5%) among 40 from Yaeyama islands, 4 (44%) and 5 (56%) among 9 from Okinawa main island, 3 (47%) and 4 (53%) among 7 from Miyako island, and 0 and 3 (100%) among 3 from other prefectures, respectively. TaxA was more frequently observed in Yaeyama Islanders compared with that of other islanders, although the difference in the distributions of the tax subgroups was not statistically significant (P = 0.077). Conclusion We found geographical difference of distribution pattern of tax genotype in each of islands of Okinawa, although there was no statistical significance. We previously reported that the prognosis of ATL patients with taxA was poorer than that of patients with taxB. The follow-up study for HCs in Okinawa is needed to clarify the differences of progression to ATL and prognosis between taxA and taxB. In addition, the comparison of gene profiling pattern between them might provide the detection of new target genes to develop a novel therapy for ATL. Furthermore, we will extend the investigation scope to Southeast Asia. It is considered that the discrepancy between the geographical distributions of tax subgroups might be related to ancient human migrations. Phylogenetic studies for HTLV-1 in Southeast Asia are expected to be a clue in revealing propagation pathway of HTLV-1 into Japan and endemic clustering of HTLV-1 in Southwest Japan.
4-6-O Developing the Active Surveillance of Larval Indices System for
Dengue Problem Solution in High and Low Risk Area of Primary Care Unit, Thailand
Charuai Suwanbamrung 1, Chanchuri Thoutong 2, Thidarat Eksirinimit 2, Suda Jaihaw 2, Supapon Tongjan 3, Seamsug Ratanasuwan 4, Kanapot Thongkew 5 1 School of Allied Health Science and Public Health, Walailak University, Nakhon Si Thammarat Province, Thailand, 80161, 2 School of Nursing, Walailak University, Nakhon Si Thammarat Province, Thailand, 80161, 3 Center for Computer Services, Walailak University, Nakhon Si Thammarat Province, Thailand, 80161, 4 Nakhon Si Thammarat Public Health Office, Nakhon Si Thammarat Province, Thailand, 80100, 5 Center of Department Control 11 Nakhon Si Thammarat Province, Thailand, 80100
Dengue is important health problem in primary care, Thailand. Objective: to develop the larval indices surveillance system based on primary care unit (PCU). Method: Community participation action research (CPAR) study was conducting the new approach for the high and low risk primary care units in Kamlone sub-district, Lansaka district, Nakhon Si Thammarat province, Thailand. There were five steps such as: 1) community preparation, 2) situation assessment, 3) develop the surveillance system, 4) Implement, and 4) evaluation. Results: Total 445 households showed both high (n=183) and low (n=262) risk PCUs such as: rural community, several water containers in and out houses, and high larval indices level. The low risk PCU (six villages) was clearly larval indices surveillance system, and stronger participate than the high risk PCU (four villages). The system consisted: 1) village health volunteers (VHVs) were divided into 3-4 zones per village, 2) VHV surveys the larval indices 10-15 households in 25th month in “violet book” and sent larval indices data to head of zone, 3) head of zone collected data from VHVs in “blue book”, 4) the head of village collected the total data from head zone in “yellow book”, 5) PCU was collecting and recording all data into program “http://Lim.wu.ac.th” in 30th month, 6) the reports were using in VHVs meeting at 13th day of month, and 7) communicating information to all stakeholders in community. Moreover, the officials of low risk PCU were coordinating, teaching, coaching, and conducting with VHVs in six villages, but the high risk PCU was working only seven steps. However, the dengue’s knowledge and larval indices’ knowledge of both PCUs were increasing significant statistic (P50% of HHs in unaffected areas did not find any change. However, around 50% of HHs complained about poor quantity or quality or no supply of piped water during a month of GEQ. The availability of overall domestic water was reduced to half or less for 50% and 57% found it very difficult to manage water. Mostly adapted strategies to manage water were storing (75%) and buying (79%). There was significant reduction in mean piped, ground and jar water amount used. Water consumption was reduced from 116 to 73 litre per capita per day (LPCD) (p 0.05; GFI = 0.99, AGFI = 0.95; NFI = 0.97; CFI = 0.98; RMSEA = 0.06; AIC = 41.52], accounting for 21.3% and 38.7% of the variance in SC services and self-efficacy, respectively. The findings illustrate that self-efficacy is a mediator that influences provision of SC services among occupational health nurses. Interventions that would enhance the nurse’s self-efficacy for providing SC services would likely promote provision of SC services.
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1-104-P Youth and tobacco in Malaysia: an alarming trends Noor Ani Ahmad, Guat Hiong Tee, Kuang Kuay Lim, Tahir Aris INSTITUTE FOR PUBLIC HEALTH Objectives: Analysing trends in tobacco used among youths will guide policy makers in planning of programmes and strategies to curb this problem. This study aims to assess the trend of tobacco used among youths aged 15 to 24 years in Malaysia from 1996 to 2015. Methods: Data from the ‘tobacco consumption’ modules from the National Health and Morbidity Surveys (NHMS) conducted in 1996 and 2006, and data from Global Adult Tobacco Survey (GATS) 2011 and Mini GATS 2015 using Tobacco Question for Survey, was analysed. These surveys were conducted as population-based survey using two-stage stratified sampling design. For NHMS 1996 and 2006, data was analysed based on CDC definition of current smokers; smoked daily or some days in the past one month, while GATS 2011 and Mini GATS 2015 defined current smokers as currently smokes at least one tobacco products every day, over a period of one month or more. Results: The prevalence of current smokers among youth aged 20-24 years increased from 23.0% (21.3, 24.6) in 1996 to 24.7% (23.2, 26.1) in 2006. Using GATS definition, the prevalence of current smokers among youth aged 15-24 years increased from 16.7% (13.6,20.3) in 2011 to 19.3% (17.6, 21.0) in 2015. In 2015, 32.9% of those current smokers smoked an average of at least 25 cigarettes per day, compared to only 5.6% in 2011. In both surveys, it was noted that majority of them prefer manufactured cigarette. More than half of those youth had attempted to quit smoking in both surveys. The percentage of those who had visited healthcare providers for the purpose of quitting smoking had reduced from 26.0% in 2011 to only 5.2% in 2015. Conclusion: The findings showed an increasing trends of current smokers among youth. More youth had become heavy smokers and less youth had visited healthcare providers for help. The findings indicate that the current strategies were not effective. More creative and innovative strategies should be employed to attract the youth who planned to quit smoking to seek professional help.
1-105-P Socioeconomic status and smoking in cars carrying children: the
intermediary roles of social norms of smoking
Junko Saito 1, Akira Shibanuma 2, Junko Yasuoka 2, Naoki Kondo 1, Daisuke Takagi 1, Masamine Jimba 2 Department of Health and Social Behavior, School of Public Health, The University of Tokyo, 2 Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo 1
Objectives The secondhand smoke exposure among young children is mostly caused by parental indoor smoking at home or cars. Exposure in cars can be particularly intense even the windows are opened, and children in low-socioeconomic status (SES) are more likely to be exposed to secondhand smoke in cars compared to high-SES children. Smoking is known as the behavior strongly affected by behaviors in close social networks. The objective of this study was to test the potential intermediary roles of social norms of smoking on the associations between SES and smoking in cars carrying children among parents who smoke. Methods We collected data from members of the online survey company using self-administered online questionnaires. The study subjects were 618 smoking fathers and 646 smoking mothers who used a car carrying their children under 6 years old in the last month. We examined two SES indicators: education years for all subjects and occupation (white/blue collar) for working subjects. For social norms of smoking, we measured two types of perceived norms: descriptive norms (how many other people smoke including close social network and the general public), and subjective norms (what significant others approve one’s own smoking behavior). We also measured household member’s smoking status and worksite smoking bans as an influential variable on social norms of smoking. We tested this hypothetical associations between SES and indoor smoking in cars using structured equation modeling approach. Results The prevalence of smoking in cars carrying children was 24.9% for fathers and 30.8% for mothers who smoke. Compared to parents in high-SES groups, those in low-SES groups were more likely to have both descriptive and subjective norms of smoking and they were associated with higher smoking in cars. For fathers, household member’s smoking status was positively associated with subjective norms, and an absence of worksite smoking bans was positively associated with descriptive norms. For mothers, neither household smoking nor worksite bans were associated with social norms of smoking. Conclusions Higher norms of smoking explains the associations between low-SES and smoking in cars carrying children among parents who smoke. Modifying parents’ pro-smoking norms might be effective to reduce socio-economic disparities in smoking in cars. Especially for fathers, interventions targeting households and workplaces might be effective to change their pro-smoking norms.
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1-106-P The Health Utilization between Smoker and Non-smoker, As Well
As Between the Family with Smoker and Without Smoker in Rural Part of Malaysia
Yiling See Toh, Hui Ting Tan, Tin Tin Su, Marzuki Isahak, Nirmala Bhoo-Pathy Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya The prevalence of smoking is high in Malaysia. We determined the health utilization among individual smokers as well as, by families with smokers in a rural Malaysian population. A population-based survey was conducted in the rural state of Pahang, Malaysia. Data was collected via intervieweradministered questionnaire at the individual level (N=2539) and household level (N=1197). Health utilization was assessed in two domains; outpatient visits (in past 2 weeks) and inpatient admissions (in past 1 year). Logistic regression analysis was used to determine whether smoking was independently associated with health utilization. 26.3% of the rural population reported to be smokers and 53.8% of the families reported to have at least one smoker in the family. Smokers were significantly older than non-smoker (median age of 48 versus 45), and comprised more males who is currently working. Among the smokers, 277 had been smoking for less than 20 years, 212 smoked for 21-39 years, and 180 smoked for >=40 years. At the individual level, participants who smoked more than 40 years were significantly more likely to attend outpatient services, than none smokers. However, this association was not significant following adjustment for age and sex. Smoking was not associated with inpatient admissions. Families without smokers were found to be less likely to have utilized outpatient services than family with smokers (45% versus 55%). This association was however not statistically significant (p=0.11). Based on this study, smoking is associated with increased usage in health care services especially outpatient visit, which may eventually increases the health expenditure and the burden of healthcare providers. Health utilization in family with smokers needs to be further studied.
1-107-P Harmful Pollution Released in Air by Cigarettes Smoking as
evidence based for Creating 100% Smoke Free Area Regulation in Surabaya Indonesia
Santi Martini 1,2, Kusuma Scorpio Lestari 2,3, Hario Megatsari 2,4, Kurnia Dwi Artanti 1,2, Sri Widati 2,4 Department of Epidemiology, Faculty of Public Health, University of Airlangga, 2 Indonesian Public Health Association, 3 Department of Environmental Health, Faculty of Public Health, University of Airlangga, 4 Department of Health Promotion and Behavior, Faculty of Public Health, University of Airlangga 1
Objective: To examine PM2.5 level in seven areas categorized as smoke free area (SFA) and smoke restricted area (SRA) and compare the results among those areas. Then the results can be a scientific evidence to create 100% smoke free regulation in Surabaya Indonesia. The regulation have to be a priority to increase public health status. Method: air quality monitoring conducted in 106 buildings in Surabaya categorized as smoke free areas such as education places, health facilities, worship places, playground areas and public transportation. Then, the areas categorized as smoke restricted areas such as work places and public places. Air quality monitoring determined by examining PM2.5 level for 60 minutes continuously. Dylos equipment used for monitoring air quality with PM2.5 as an indicator of cigarette smoke exposures. Results: More than 50% indoor areas (56 buildings) had higher PM2.5 level than WHO standard (more than 25 μg/m3). Based on type of areas, the highest percentage of buildings having PM2.5 level more than WHO standard was public places (69.2%) and the lowest percentage of it was worship places (20%). Then, the other areas having PM2.5 level more than WHO standard were 58.3% of playground places, 40% of public transportation, 37.5% of health facilities, 26.7% of education facilities and 21.4% of work places. Furthermore, the highest average level of PM2.5 was 75.7 μg/m3 at public places. On the other hand, the lowest average level of PM2.5 was worship areas (17.2 μg/m3). For other areas, the average level of of PM2.5 were 41.9 μg/ m3 at playground areas, 36.3 μg/m3 at public transportation, 33.1 μg/m3 at health facilities, 25.9 μg/m3 at education facilities and 20.8 μg/m3 at work places. Conclusions: Most of those indoor areas either in smoke free areas (SFA) and smoke restricted areas (SRA) had higher level of PM2.5 than WHO standard and the highest level of PM2.5 was at public places. This evidence showed that 100% smoke free regulation have to be enacted.
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1-108-P The impact of tariff rates of cigarettes on global smoking
prevalence trends
Tzuying Chen 1, Feng-Jen Tsai 2 Institute of Health Policy and Management, National Taiwan University, 2 Master Program in Global Health and Development, College of Public Health and Nutrition, Taipei Medical University 1
Objectives: This study aims to represent the trends of tariff rates of cigarettes and smoking prevalence and discuss the impact of tariff rates of cigarettes on global smoking prevalence trends. Methods: The tariff rates of cigarettes and smoking prevalence from 109 countries were collected. The MFN tariff rates and FTA duties of cigarettes containing tobacco (HS Code: 240220) during 1995 to 2014 for this study were obtained from the WTO website. The smoking prevalence of countries of male and female during 2000 to 2012 in the world were obtained from The World Bank. The EXCEL program was used to implement the trends of the data. Results: Trade liberalization may have more effects on lower income level countries than higher income countries. FCTC treaty is limited to affect international trade, but may have slightly influences for low income level countries to increase the tariff rates of cigarettes since the restriction from FCTC may assist the governments to form their own regulations. The trade liberalization only affects the trend of male smoking prevalence of low income countries since the main export countries may sharply cutting the tariff rates of low income level countries in negotiation, and lacking of domestic policies. In Taiwan’s case, implementation of “Tobacco Hazards Prevention Act” in 1997 and the “health and welfare surcharge on tobacco products” effectively decreased the smoking prevalence in Taiwan. Conclusions: Trade liberalization may have more effects on low income level countries than higher income countries since the low level countries may be sharply cut their tariff rates by main export countries in negotiation, and lacking of domestic policies. FCTC treaty is limited to affect international trade but may assist the governments of low income level countries to form their own regulations. In Taiwan’s case, implementation of “Tobacco Hazards Prevention Act” in 1997 and the “health and welfare surcharge on tobacco products” effectively decreased the smoking prevalence in Taiwan, which offset the negative impact from trade liberalization.
1-109-P Trends of current tobacco smoking among Malaysian adults from
1996 to 2015: A cause to worry?
Guat Hiong Tee, Mohd Azahadi Omar, Noor Ani Ahmad, Kuang Kuay Lim, Tahir Aris, Ying Ying Chan Institute for Public Health, Ministry of Health Malaysia Objective To examine the trends of current tobacco smoking among Malaysian adults aged ?18years and the intensity of cigarette smoked per day from 1996 to 2015. Methods Data were obtained from four surveys: National Health & Morbidity Survey in 1996 and 2006, Global Adult Tobacco Survey (GATS) in 2011 and 'Mini-GATS' using Tobacco Questionnaire for Survey in 2015. These were nationally representative household surveys using multi-stage cluster sampling design. Data were collected via face-to-face interviews from selected respondents. Sample weighting and analyses were carried out using appropriate complex sample statistical tools. Current tobacco smoking was defined as currently smoking or using smokeless tobacco either daily or occasionally. Results The overall prevalence of current tobacco smoking decreased significantly from 24.7% (24.1-25.4) in 1996 to 22.8% (22.3-23.3) in 2006; and increased to 24.6% (22.5-26.7) in 2011 and remained unchanged at 24.0% (23.0-25.1) in 2015. Significant decline of current tobacco smoking was observed in women from 1996 to 2011; the decline was not significant among men over the past two decades. Decreasing trend of tobacco smoking with increasing age was seen in 1996. However, decreasing trends of smoking were only observed from 30-39 years to ?60 years in 2006 and 2011 and from 40-49 years to ?60 years in 2015. Rural residents smoked more than urban dwellers. By ethnicity, 'others' ethnic group smoked the most. Trend of smoking with education levels varies; smoking increased from no formal education to primary and decreased from secondary to college or above education levels in 1996 and 2011. The decreased in smoking prevalence started from those with secondary or completed high school to college education was seen in 2006 and 2015. The average number of cigarettes smoked per day decreased from 13 (13.39-13.41) to 12 (11.94-11.96) sticks in 1996 and 2006 but increased significantly to 14 (14.03-14.04) and 18 (18.28-18.32) sticks in 2011 and 2015. Conclusion Tobacco smoking remained high over the last two decades. Men, those ?40 years, rural residents and 'others' ethnic group were at the greatest risk of tobacco smoking. Thus, to further reduce the smoking prevalence and achieving endgame for smoking in 2030, tobacco control intervention should target this segment of Malaysians.
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1-110-P Fulfillment of Treatments and Drug Use Patterns in Referral
Programs of Pharmacies
Surya Dwi Sembada 1, Kuswinarti Sumarlan 2, Nita Arisanti 3 Faculty of Medicine, Universitas Padjadjaran, 2 Departement of Pharmacology and Therapy, Faculty of Medicine, Universitas Padjadjaran, 3 Departement of Public Health, Faculty of Medicine, Universitas Padjadjaran 1
Background: Program Rujuk Balik (PRB) is one of Indonesia’s Jaminan Kesehatan Nasional (JKN) scope organized by Badan Penyelenggara Jaminan Sosial Kesehatan (BPJS Kesehatan) recently started in early 2014. All members in this program have a right to obtain medication for 30 days from pharmacies collaborate with BPJS Kesehatan. A report reveals a month after program implementation, not all members have obtained medication as it prescribed. This study is conducted to observe number of prescribed medication and the patterns of drug used by pharmacies. Method: A descriptive quantitative study was carried out by comparing the number of prescribed medications with the number of prescription should be given and number of indications with total indications of prescription in October 2015 from two pharmacies. The collected data was the type of medication, indication (according to the National Formulary), quantity, and frequency of medication from both pharmacies. Informed consent had been approved by the BPJS Kesehatan and pharmacies. Results: More than 95% prescribed medication in PRB had been fulfilled by collaborated-pharmacies with the highest pattern of drug usage for hypertension (84.09%), followed by diabetes mellitus (37.52%) and heart disease (12.72%). Conclusion: Most of prescribed medication in PRB have been fulfilled by pharmacies and antihypertensive drugs as the highest prescribed medication. Monitoring of drugs distribution and availability in collaborated-pharmacies should be improved and followed up periodically to ensure the success of PRB. Keywords: BPJS Kesehatan, Pharmacy, Prescription, Program Rujuk Balik
1-111-P INTERIOR DESIGN EFFECT ON MOTIVATION OF HEALTH
PROVIDER IN PROVIDING HEALTH CARE
Honesty Pujiyani, Octavian Tiara Kasih, Permatasari Adhyaksa Karini, Novia Ariyanti Universitas Gadjah Mada Objective: To determine the influence of interior design on the motivation of health provider in providing health services. Methods: This was a cross sectional study. Quantitative data were collected through questionnaires. Data from the target group of health sector personnel were mostly obtained through group interviews consisting of 50 personnel recruited according to availability. Quantitative data were analyzed by the SPSS 21.0 software program. Descriptive statistics was employed to illustrate the characteristics of the sample. The influence of design the interior of room for health services analyzed by Chisquare test. Result: A hospital interior design affects the motivation of medical personnel in providing health services by 96.6% (R=0.966). Conclusion: Interior design can create the motivation of health personnel in order to provide a quality service.
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1-112-P Fulfillment of Treatments and Drug Use Patterns in Referral
Programs of Pharmacies
Surya Dwi Sembada 1, Kuswinarti Sumarlan 2, Nita Arisanti 3 Faculty of Medicine, Universitas Padjadjaran, 2 Departement of Pharmacology and Therapy, Faculty of Medicine, Universitas Padjadjaran, 3 Departement of Public Health, Faculty of Medicine, Universitas Padjadjaran 1
Background: Program Rujuk Balik (PRB) is one of Indonesia’s Jaminan Kesehatan Nasional (JKN) scope organized by Badan Penyelenggara Jaminan Sosial Kesehatan (BPJS Kesehatan) recently started in early 2014. All members in this program have a right to obtain medication for 30 days from pharmacies collaborate with BPJS Kesehatan. A report reveals a month after program implementation, not all members have obtained medication as it prescribed. This study is conducted to observe number of prescribed medication and the patterns of drug used by pharmacies. Method: A descriptive quantitative study was carried out by comparing the number of prescribed medications with the number of prescription should be given and number of indications with total indications of prescription in October 2015 from two pharmacies. The collected data was the type of medication, indication (according to the National Formulary), quantity, and frequency of medication from both pharmacies. Informed consent had been approved by the BPJS Kesehatan and pharmacies. Results: More than 95% prescribed medication in PRB had been fulfilled by collaborated-pharmacies with the highest pattern of drug usage for hypertension (84.09%), followed by diabetes mellitus (37.52%) and heart disease (12.72%). Conclusion: Most of prescribed medication in PRB have been fulfilled by pharmacies and antihypertensive drugs as the highest prescribed medication. Monitoring of drugs distribution and availability in collaborated-pharmacies should be improved and followed up periodically to ensure the success of PRB. Keywords: BPJS Kesehatan, Pharmacy, Prescription, Program Rujuk Balik
1-113-P Comparing the practice of health and environment co-benefits
behaviors at years of 2008 and 2016 among Hong Kong population
Susan Shuxin Wang, Emily Ying Yang Chan, Zhe Huang, Janice Ying-En Ho, Kevin Sida Liu CCOUC for Disaster and Medical Humanitarian Response, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong Objectives: Some carbon-reducing behaviours are environmental-friendly and good for health. Such co-benefits are promoted since the millennium in Hong Kong (HK). This study aims to found out how the practice of these behaviours may have changed during the past decade in HK. Methods: This 2-stage sequential randomized cross-sectional and population-based telephone survey collected data in 2008 and 2016. Six kinds of behaviours (less electricity, less unnecessary package, less A/C, less meat, more walk/cycling, and more organic food) were investigated. The respondents self-reported their practice for each behaviour and their demographics (age, gender, education, occupation, and living area). Descriptive analysis shows the percentage of respondents doing each behaviour in 2008 and 2016, while comparison is determined by χ2 test and logistic regression with adjustment of demographic factors. Results: The 2008 survey regarding climate change with 1000 respondents included the practice of co-benefits behaviours. The 2016 survey received 1017 completed questionnaire with 63% response rate. The 2 study samples are comparable by age, gender, district and with government census. Improvements were found in consuming less unnecessary packaging or shopping bags, using less air conditioning, eating less meat, and purchasing more organic food. No significant difference was found in using less electricity, neither walk/cycling more. Doing less packaging increased from 91.4% to 95.7% with odds ratio (OR)=2.04 (95%CI=1.38-3.03, p500 ml per day, 0.30 (95% CI 0.18, 0.48) for drinking >5 cups per day, 0.53 (95% CI 0.30, 0.94) for drinking > 30 years, and 0.35 (95% CI 0.16, 0.64) for a cumulative exposure of 80 cup-years or more, relative to their respective low level of tea consumption. The inverse association was found in all cancer grades, but stronger among patients with a higher grade (Gleason score ?8?), where the adjusted odds ratio was 0.54 (95% CI 0.30, 0.97) for tea drinkers when compared to non-drinkers. The corresponding dose-response relationships were also significant (p < 0.01). Conclusion: Habitual tea consumption is associated with reduced risk of prostate cancer in Vietnamese men, consistent with previous epidemiological evidence from other Asian populations.
2-002-P SMOKERS AND EX-SMOKERS THE SAME AS HAVING THE RISK OF
CERVICAL CANCER IN INDONESIA
Besral Besral, Ivan Arif Pratama University of Indonesia Background: Cervical cancer is cancer that often strikes women in the world. One of the factors precipitating these cancers are smoking behavior. The proportion of smokers among Indonesian women has increased every year. Objective: This study aimed to assess the effect of smoking behavior and ex-smokers on the risk of cervical cancer. Method: Using a cross-sectional study design, as much 216,797 women respondents aged over 20 years using data of Basic Health Risearch year 2013 collected from 33 provinces in Indonesia. Results: The prevalence of cervical cancer is 12 per 1,000 women over 20 year (95% CI = 9-14 per 1,000). Women who smoke daily have 2.4 times greater risk of suffering from cervix cancer. Women ex-smoker, ever smoked every day, had a 8.2 times greater risk of suffering from cervix cancer. Other risk factors for the cervical cancer were age, abortion, having sex under 18 years old, high economic status. Use birth control pills have a lower risk of cervical cancer. Those woman with aged over 50 years had a 2.6 times greater risk of suffering from cervical cancer. Women who have a history of abortion 1.6 times greater risk for cancer cervix. Women who have had sexual intercourse under the age of 18 years have a 1.9 times greater risk for cancer cervix. Middle or lower economic groups have a lower risk for cancer cervix, respectively 0.6 and 0.3 times lower the risk than the rich group. Women who use birth control pills have a 0.7 lower risk of cervical cancer. Conclusions: Smoker and ex-smoker the same as having the risk of cervical cancer in Indonesia. It is suggested to women from an early age and young women to never touched a cigarette, once you consumed then various dangers of the disease will threaten your life, including the threat of cervical cancer. Strong policies are needed from the government to avoid the dangers of teen smoking
155
2-003-P The Effects of Regular Source of Care on Avoidable Hospitalizations
Among patients with Chronic Obstructive Pulmonary Disease (COPD)
Ipo Lin Department of Health care Administration, Oriental Institute of Technology Objective: To examine the relationship between regular source of care and avoidable hospitalizations Methods: This study adopted a retrospective cohort study design. The main data source was the Longitudinal Health Insurance Database 2005 which included data from one million beneficiaries, that was randomly sampled from all National Health Insurance enrollees in Taiwan in 2005. The study population included 2,643 subjects who were diagnosed with confirmed COPD in 2006. The dependent variable was COPD-related avoidable hospitalization. The Usual Provider of Care (UPC) was used to evaluate subjects whether or not they had a regular source of care (RSOC). The subjects were classified as having a regular source of care if the value of UPC was 1. Every subject was traced for 3 years after the date of confirmed diagnosis. For the first 2 years, UPC measures were evaluated, whereas in the last year, the measures were evaluated for health outcomes. Statistical analysis included descriptive statistics, t-test and chi-square test. A logistic regression model was used to control for sex, age, low-income status, and health status. All analyses were conducted using SPSS 12.0 and SAS 9.2. Results: Across the entire sample, 35.1% subjects had RSOC, 63.7% were male, 34.2% were 4 cup per day compared to non-tea drinking group, adjusted ORs were 1.00 (95% CI 0.67, 1.48), 0.76 (95% CI 0.55, 1.05), and 0.59 (95% CI 0.40, 0.87), respectively. Cumulative exposure of tea consumption including cup-years (>20) and duration of tea consumption (>10 years) were inversely associated with T2D compared to their non-drinking counterparts; adjusted ORs were 0.65 (95% 0.47, 0.91) and 0.66 (95% 0.47, 0.92), respectively. No interaction term was found between tea consumption and sex on odds of T2D. Conclusion. Our present findings supported the concept that habitual tea consumption may be a protective factor for T2D.
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2-005-P Validation of the equation for estimating daily sodium excretion
from spot urine in patients with CKD
Hoichi Amano 1,2, Masaaki Matsuura 1, Seji Kobayashi 2, Yosindo Kawaguchi 2, Kazue Yamaoka 1 Graduate School of Public Health, Teikyo University, 2 Division of Nephrology and Hypertension, The Jikei University Hospital 1
【Objective】Salt intake is widely recommended for limitation 6g/day or less in patients with CKD (Chronic kidney disease: CKD).It is important that the salt intake of the patient individual in medical treatment is grasped. Some equations of the daily sodium excretion from spot urine were made widely but these estimated expressions are made for healthy people. There are few reports that validation of the equation in CKD patients.The purpose of this study is to estimate the daily sodium excretion from spot urine in patients with CKD.【Method】163 patients with CKD from Kanagawa Prefectural Shiomidai Hospital and the Jikei University Kashiwa Hospital participated in the present study. Daily sodium excretion was established from spot urine by using Tanaka et al (J hum Hypertensions 002; 16:97-103).【Result】Daily sodium excretion was 2,744 ± 1,330 (mean ± SD) mg/day and estimating daily sodium excretion from spot urine was 3,315 ± 996(mean ± SD) mg/day. Estimated regression coefficient was 0.309 (p 0.05) shows no statistically significant association to treatment outcome of the patient. Conclusions & Recommendations: Patients with epilepsy attending epilepsy clinic at NHSL had a better knowledge on treatment than on the disease. There were room to improve treatment outcome of the patients. it is recommended that health education for the patients should focus improving knowledge on disease and treatment. Relationship between the treatment outcome and other factors should be further studied.
2-182-P ANALYSIS OF PROGRAM IMPLEMENTATION CARE SUPPORT
AND TREATMENT TO PEOPLE LIVING WITH HIV AIDS (PLWHA) IN YOGYAKARTA
Pariawan Lutfi Ghazali, Irma Noor Budianti Department of Public Health, Faculty of Medicine, Islamic University of Indonesia Objective : To analyze the activity program Care Support and Treatment to the people with HIV AIDS (PLWHA) in Yogyakarta Method : Subject are patients living with HIV, chairman of the KEBAYA, Social Service and the companion activities of CST such ad muslim religion teachers, Doctors and psychologists. This research is qualitative study tha collected data throught interviews and observations. Results : : Program Care Support and Treatment (CST) in Yogyakarta were carried on in the NGO KEBAYA has been running since 2014. The CST program is able to provide the waiter to people living with HIV care, support and treatment. Although it had the support of local government such as the Social Service program CST but not fully get the attention of the central government. In this study CST program running requires a special shelter in which PLWHA require training on PLH mainly to train counselors in NGOs KEBAYA. CST program is still very constrained cost. Conclusion : Care Support and Treatment program implemented at KEBAYA consist of supportive care and treatment, could motivate the people living with HIV, provide assistance and support to physical, psychological, mental and spiritual. It also allows people living with HIV to access health services by using JAMKESOS. CST program received financial fund from the Goverment which are basic needed necessities, food and hygiene kits.
245
2-183-P Community network to development health promotion program
among community-dwelling elderly in Khon Kean province, Thailand: Qualitative study
Uthaiwan Nukat, Piyathida Kuhiranyaratn Department of Community Medicine, Faculty of Medicine, Khon Kaen University Objective: In development health promotion program to be effective and sustainability, Partnerships of community is very important. Stakeholder analysis so there is very necessary, this study aims to identify the stakeholders of a community network and their role to development health promotion program among community-dwelling elderly. Methods: This is qualitative research, an ethnographic study was conducted. The in-depth interview guideline was reviewed by experts was used to in-depth interview the key informants who have involved health promotion among communitydwelling elderly in one sub-district of Khon Kean province, Thailand until the data-saturated. The key informants included elderly, caregiver, community leader, health volunteer, religious leader, leadership training, health worker and municipal worker are total of 24 peoples. Triangulation was used for data analysis. Results: Stakeholders of a community network to development health promotion program among community-dwelling elderly are classified to five levels as Individual, Family, Community, Local government and Health professional level. There are comprise of own elderly, caregivers, neighborhood, community leader, health volunteer, Elderly club, religious leader, leadership training, municipal, health worker, nurse and nurse professor. The formal role is primary function of Local government and Health professional includes health screening, provide information, funding sources and severe the environment conducive to elderly health promotion. The informal role is supporting of Family and Community includes encouragement, support information and leadership in healthcare. Finally own elderly that play role in controls their health promotion behaviors. Conclusion: Stakeholder involvement is an important process and has to be carefully planned, implemented and followed-up to development and running for appropriate health promotion program among community-dwelling elderly to foster sustainability.
2-184-P Intra-articular Injection of Synovium-Derived Mesenchymal Stem
Cells with HA Can Repair Articular Cartilage Defects in a Canine Model
Shinya Miki, Masato Takao, Hitrotaka Kawano Teikyo University Objectives: The purpose of this study was to evaluate effectiveness of intra-articular injection of Synovium-derived mesenchymal stem cells (SMSCs) and hyaluronic acid (HA) for the treatment of articular cartilage defects in a canine model. Methods: Forty-eight knees of 24 adult beagle dogs were randomly assigned to 16 groups by the combination of the number of SMSCs(0, 5×105 cells, 5×106 cells, or 5×107 cells) and concentration of HA (0%, 0.01%, 0.1%, or 0.5%). At first, a partial-thickness cartilage defect (4-mm-diameter; 16-mm2) was created in the medial femoral condyle and synovium was also harvested from knee joint under arthroscopy simultaneously. Seven weeks after surgery, injection of cultured SMSCs with or without HA was performed in each group. As for a control group, lactated Ringer’s solution was injected. Nineteen weeks after surgery, all dogs were sacrificed. Evaluation was performed by determining International Cartilage Repair Society (ICRS) macroscopic score and modified O’Driscoll histological score. Results: The mean ICRS macroscopic score was 1.0 ± 0.00 and the mean modified O’Driscoll histological score was 11.0 ± 0.00 in control group. On the other hand, the mean ICRS macroscopic score and the mean modified O’Driscoll histological score were 7.3 ± 2.62 and 30.7 ± 5.91 in 5×10? cells with 0.01% HA injection group. In addition, there was one case which showed almost complete coverage of the defect with evidence of hyaline cartilage regeneration in 5×106 cells with 0.01% HA injection group. Conclusion: Intra-articular injection of SMSCs with HA may be an effective method for stimulating articular cartilage defect repair.Our results suggest that the combination of the proper number of SMSCs and the proper concentration of HA for articular cartilage repair would exist.
246
2-185-P How Games Keep the Memory and Mental Functioning Among the
Elderly: A Study on Chess in China
Shizhen He 1, Yuwen Wang 2 Department of Public Health, Xi'an Jiaotong-Liverpool University, 2 Department of Economics, Xi'an JiaotongLiverpool University
1
Objectives Population is rapidly aging in many Asia-Pacific countries making elderly health an important issue. One of the major concerns is having a good memory and mental facility amongst this group such as the use of mental games. Several forms of chess games are very popular in the region. This paper explores how Chess games help the elderly with their memory through a study in China. Methods Paper and online questionnaires are used to collect data. Data was encoded in Excel file. R was used to analyze the data. Aging was defined as 50 and above. Old chess players were found in some chess game rooms in some communities. Interviews were conducted and assistance was provided to fill the questionnaire. An online questionnaire was opened in websites. Results This is an ongoing study. So far, 107 responded to the questionnaire. After cleaning the data by deleting those who do not qualify as elderly and do not play chess, 24 respondents were considered. The current sample consists of 4 females and 20 males. The sampling will continue until the sample size is over 100. Among these 24 respondents, the average age of starting playing chess games is 18. These respondents have played chess games for 30.7 years on the average and 13 of them have played chess for more than 31 years. Compared with other 11 respondents, these 13 respondents who have played chess for more than 31 years are more convinced of the benefits of playing chess on memory. All 24 respondents agree that chess games can help them keep memory (9 strongly agree). 20 respondents (83.3%) agree that chess games can help them maintain good thinking (12 strongly agree). Socialization has a role in playing chess. 22 respondents agree that this help them make and keep friends (12 strongly agree). 21 respondents agree that chess games can improve the mood (11 strongly agree). 13 respondents who live with their children are more convinced of the benefits of playing chess compared with others. Results confirm that training the brain in problem-solving across the life span keeps the neural networks active. Conclusion Chess games play a big role in helping the elderly keep their memory and mental functioning. Chess games and possibly other forms of mental games can be mainstreamed as a public health program for the elderly in many countries.
2-186-P How to cheer up the institutional elderly?Effects of intervention
based on mental health promotion activities and indoor golf games
Hsiu Fan Hsu 1, Yi Chen Chiang 2, Yu Jung Lin 1 School of Public Health, Chung Shan Medical University, 2 School of Public Health, Xiamen University
1
How to cheer up the institutional elderly? Effects of intervention based on mental health promotion activities and indoor golf games Hsiu-Fan Hsu1, Yi-Chen Chiang2,*, Yu-Jung Lin1 1 School of Public Health, Chung Shan Medical University, No.110,Sec.1,Jianguo N.Rd., Taichung, 40201, Taiwan 2 School of Public Health, Xiamen University, Xiamen 361102, Fujian, China * Corresponding Author. Objectives: Design a mental health activities and indoor golf game promotion intervention programs and involvement in this program explore the possibility of upgrading the happiness of institutions for the elderly and the elderly reduce depression mood. Methods: A total of 118 older adults (aged 65 years and over) living in four well-organized long-term care centers in Taiwan were included in the intervention and control groups. A pretest, post-test, and post-posttest design was used in the longitudinal study. In addition to a measure of the subjective well-being (mini-version), GDS (short form) among institutional elderly people, heartbeat and blood pressure variation were recorded using smart watches. Results: After the mental health promotion activities and indoor golf games, the depressive mood was significantly reversed and the happiness was noted in the intervention than the control group. Furthermore, all the individuals had sustained effects after one month. In addition, we found that the "indoor golf games for the elderly" improved variations in heart rates after 20 minutes showing that intervention program could improve the well-being of the elderly. Conclusions: Intervention program could be an effective and executable model for institutional-dwelling older adults. We hope to promote its use in other long-term care agencies and to stress the importance of mental health promotion in the institutional-dwelling elderly adults. ・Title number of words : 21 words ・Total number of words : 213 words
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2-187-P The Relationship between Physical Activity And Internet Addiction
Disorder In Chinese College Students
Xuhao Yang, Qiqiang He School of Public Health, Wuhan University Objective: To investigate the association between college students’ physical activity and Internet Addiction Disorder (IAD). Method: A cross-sectional study was conducted in Wuhan, China from April to May, 2013. Information for college students’ physical activity and IAD were obtained by self-administered standardized questionnaires. Results: Among a total of 1279 students (aged 20.34±1.04 years old, 576 boys) included in the final analysis, 319 (24.9%) students were identified as having IAD. After adjusting for confounding factors, male students engaging in moderate and heavy physical activity showed decreased odds ratios (OR) for IAD, with 0.51(0.32,0.79) and 0.43(0.22,0.74), respectively, while female students who had engaged in moderate and heavy physical activity also had lower risk for IAD, with OR: 0.60(0.39,0.89) and OR:0.49(0.31,0.77), respectively than their counterparts. Conclusions: There was a significant link between physical activity and IAD among Chinese college students.
2-188-P Association of rearing, family connection, personal characteristic
and alcohol drinking with violence behavior among Thai adolescent
Wasinee Wongin 1,2, Suchada Paileeklee 1 faculty of medicine, khon kaen university, 2 suratthani provincial health office
1
Objectives To investigate the association of family rearing and connection, personal characteristics and alcohol drinking with violence behavior among Thai adolescent. Methods A case-control study was conducted in adolescent aged 15-19 in 6 provinces of6 regional area in 2014. Cases were 240 adolescent with history of violence behaviorin Juvenile detention home. Controls were 960 students without violence behavior in Secondary school. Data were collected using self-administered questionnaire, then were analyzed to obtain frequency, percentage, OR and AOR. Results Almost all cases were boy (93.8%), age 18 and 19 years old (37.1% and 25.8%). Most of the control were girl (73.5%), aged 15 and 16 years old (32.4% and 29.2%). Most of adolescent reported that family rearing were reasoned rearing (54.2% and 71.4%), whilst spoiled andcontrolled rearing were 22.9%, 20.4%, and 7.2%, 18.8%, among case and control respectively. Both case and control had high level of family connection (82.1% and 93.2%).Among case and control,63.3% and 50.2% had negative characteristics,85.8% and 22.6% drinking alcohol. Most of cases ever involved in quarrel and fighting (70.0%), and 53.8% ever involved in quarrel and fighting resulting in injuries and medical treatment. Whilst, 4.8% of controls ever involved in quarrel and fighting. Half of cases (51.7%) but 0.8% of controls ever draw out the knife or gun to the others. The factors that significantlyincreasing risk of violence behavior were spoiled rearing (OR4.22, 95%CI; 2.76-6.45), low to medium level of family connection (OR 3.01,95% CI; 1.98 - 4.58), negative characteristics, (OR 2.87,95% CI; 1.84 - 4.50), and alcohol drinking (OR 20.76, 95% CI; 13.98 - 30.81). Multiple logistic regression reported that factors increasing risk of violence behavior werespoiled rearing (AOR 4.81, 95%CI 2.75-8.38), control rearing (AOR 1.71, 95% CI; 1.07 - 2.71), low to medium family connection (AOR 3.57, 95% CI=2.04 - 6.25),negative characteristics (AOR, 2.75, 95% CI;1.60 - 4.73), and alcohol drinking (AOR 21.54, 95% CI; 14.07 - 33.00). Conclusion The study revealed that alcohol drinking contributing very high riskof violence behavior among Thai adolescent. Family rearing, familyconnection, and negative characteristics presented AOR of 1.71-4.81. These factors are needed to be addressed in social problem prevention program. 248
2-189-P Understanding Iron-rich Food Consumption among Adolescent
Girls in Indonesia and What Can We Do about It?
Ratri Ciptaningtyas 1,2, Djajadiman Gatot 3, Saptawati Bardosono 4, Judhiastuty Februhartanty 2 Public Health Department, UIN Syarif Hidayatullah, 2 Community Nutrition SEAMEO RECFON, Faculty of Medicine, Universitas Indonesia, 3 Pediatric Department, Faculty of Medicine, Universitas Indonesia, 4 Nutrition Department, Faculty of Medicine, Universitas Indonesia 1
In Indonesia, nearly 1/3 of all women of reproductive age are anemic, more specifically 22.7% of non-pregnant and 37.1% of pregnant women of reproductive age. Intervention given to adolescent girls equal with investing in girls and young women before marriage and first pregnancy. This study aims to understand the determinants of food consumption as a consequence of anemia from the perspective of behavioral theory and to find behavior communication change (BCC) channel that is appropriate for future intervention. Qualitative approach was used by conducting FGD among adolescent girls at sub urban school in Indonesia. Indepth interview to teacher, school principal and parents and observation to food availability at school and home were also applied to support discussion. Anemia is a familiar terminology among adolescent girls. However, they are more exposed to this terminology from iron supplement commercial advertisement rather than nutrition information from health education handbook or health officers. In addition, consume iron-rich food such as red meat not only rare but consider as bad because it contains more fat and can gain their weight. Parents have important role in shaping their food consumption habits at home but not at school. Despite incorrect of balanced nutritional concept, school officers care about food safety. They managed to negotiate with food vendors for selling type of food. It has positive impact to contribute girls’ food consumption. Limited nutritional information, make reaching girls with nutritional messages in this period when they are susceptible to other opinions has the potential to influence their food consumption. Literatures search show adolescents nowadays are more attached to personal communication device. Android is the most popular smartphone operation system they possess. We asked the girls’ opinion on android application that provide information on anemia. The application also user interface that allows users to input their food diary and to pop up reminder on anemia-related food consumption. This is considered as promising intervention channel to reach this target group with relevant and impactful interventions. It is interesting to know that the perception on iron-rich food is a constrain to have adequate iron intake. Android application as a novel channel for changing behavior is developed to load the girls with apropriate nutritional information. Author no.1 developed android application Remaja Putri Anti Anemia
2-190-P Index of Pufa in Age 6 to 7-Year-old Children in a Selected
Community in Indonesia
Vinni Nichianishi, Sjazili Muhibat, Asty Samiati Setiawan faculty of dentistry, padjadjaran university Caries is still a major problem for children. The untreated dental caries could effects infection of pulpa and abnormalities of surrounding soft tissue. Index of pufa is an index to record the effect of untreated caries on deciduous teeth. This study aims to determine the description of index pufa score effect of untreated caries in 6 to 7-year-olds children in elementary school in Garut city, Indonesia. The research methods used was survey and sample taking by using total sampling technique. The research was conducted at Cijayana 1 and Jagabaya 2 elementary school, Garut city and obtained 57 students with sample age between 6-7 years olds. The data was acquired through clinical examination for pufa. The result showed that mean of index pufa on students elementary at Cijayana 1 and Jagabaya 2 is 2.6. The findings of the research showed that Dental Health in students elementary at Cijayana 1 and Jagabaya 2 was in bad. Keywords: Dental Caries, Dental Health, Index of pufa
249
2-191-P To investigate Humor style effect between social network on
bullied experience and mental health among junior high school student in Taiwan.
Yu Jung Lin 1, Yi Chen Chiang 2, Wen Chi Wu 3, Hao Jan Yang 4 1 School of Public Health, Chung Shan Medical University, 2 School of Public Health, XiamenUniversity, Xiamen 361102, Fujian, China, 3 Department of Healing Science and Health Marketing, School of Healthcare and Management, Kainan University, Taoyuan, Taiwan, 4 Department of Family and Community Medicine, Chung Shan Medical University Hospital, Tai-Chung, Taiwan
Objectives: School bullying is a serious problem in the world. Importantly, bullying has linked to many negative outcomes, including mental illness, substance use, and suicide. Particularly, past studies have found that social network indicator appears to be one of the strongest predictors of bullying. However, humor and laughter have also been regarded as helpful mechanisms for relieving tension in the body and protecting the body and spirit. The purpose of this study was to explore which humours style can moderate social network indicator between bullied experiences and mental health. Methods: A total of 2, 474 students from grade 7 to grade 9 were involved in the study. Social network indicators derived from peer nomination to classify the numbers of indegree and outdegree. Bullied behaviours were be classified into three types as physical, verbal and relation. The classification of humor expressions was based on the Taiwan Adolescent Humor Instruments (TAHI). We used UCINET, SAS, and LISREL to verify our hypotheses. Results: The highest proportions of students with verbal bullied experience were observed. We further found that lower indegree and higher outdegree were more likely to be bullied (physical/verbal/ relational). In particular, using negative humor style (Self-deprecating and other-devaluing) will increase bullied experiences and had moderate effect between social network indicator and bullied experience. Conclusion: Social network indicators were significantly associated with bullied experience and mental health. In particular, negative humor style is an important moderate factor. Thus, teachers should consider teaching positive ways of humor performance in every school period.
2-192-P Effectiveness
Leaf Beluntas Extract (Pluchea indica L) as Biolarvacide Against Aedes aegypti Larvae Instar III
Nur Afiaty Mursalim Department of Enviromental Health, Alauddin Islamic State University, Indonesia Background: Dengue Haemorrhagic Fever (DHF) is a disease caused by Dengue virus and infected by Aedes aegypti mosquito that is indicated by acute fever for about 2-7 days followed by the nuisance oncapillary blood artery and blood freezing system so that, it caused bleeding and even death. Some factors that influence the spreding increase of DHF case are very complex they are population growth, no effective mosquito control in endemic. Any expedient to fight against the diseases by controlling the vector has been done, both chemically and naturally. Dengue disease is one public health problem in the countries that has the tropical climate, including Indonesia. DHF has a very rapid clinical course and often leads to death due to delayed treatment.The use of synthetic chemical insecticides especially larvacide leave residues that have a negative impact on the environment, so the natural larvacide research was developed to reduce the negative impact of chemical larvacide. The application of Abate in water as the larvacidal, resulted resistency to the larvae. Leaf Beluntas (Pluchea indica L) have been reported to contain bioactive substances. It is also probable containing larvacidal substances against the (Aedes aegypti) larvae. The purpose of this study was to determine the effectivenes leaf beluntas extract (Pluchea indica L) as a larvacide. Methods: The study design used was experimental, using completely randomized design. Trials were divided into 6 groups, namely 0% (negative control), 0.25%, 0.5%, 0.75%, 1% and 1% abate (positive control). The number of samples used in this study was 600 larvae. Each group contains 25 larvae in 100 ml solution containing ethanol leaf beluntas extract. Repetition done 4 times and given food fish during the study. Results: Test used is the Kruskal-wallis test (p 11mmol/L was recorded as diabetes. It has revealed only a tendency between dimethyl phosphate levels in hair and diabetes (P=0.052). The quality rating of the study was fair. Conclusion Although the main objective of the selected study was not related to our objective, it has laid a useful platform. Future studies should compare hair sampling with the traditional (blood and urine sampling) methods.
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2-195-P What strategies do mothers do to balance work and child rearing Yuka Arao 1, Megumi Fugita 2, Sanae Yamaguchi 2 Yamagata university graduate school of medicine masters program nursing department, 2 Yamagata university faculty of medicine
1
Objective: To clarify the kinds of strategies mothers with preschool-aged children use in their everyday lives to balance work and child rearing.Methods: Mothers (N = 506) of pre-school children responded to a self-administered questionnaire consisting of 36 items concerning attributes and strategies related to balancing work and child rearing. We received 188 valid responses, on which we conducted factor analysis using the principal components method with Promax rotation.Results: To establish the factor loadings,we selected the 34 items that had more than 0.3 on one factor. We extracted six factors with a cumulative variance of 47.1% and a reliability coefficient (Cronbach's α) of 0.82. The first factor, “allotment and coordination of housework duties and connect with the community,” consisted of 15 items with a reliability coefficient of 0.82. The second factor, “use of social systems,” consisted of 5 items with a reliability coefficient of 0.72. The third factor, “personal emotional attitude,” consisted of 2 items with a reliability coefficient of 0.48. The fourth factor, “consultation with management and job coordination in the workplace,” consisted of 4 items with a reliability coefficient of 0.48. The fifth factor, “strategies for time management of household tasks,” consisted of 6 items with a reliability coefficient of 0.46. The sixth factor, “security of persons and parties with whom children can be entrusted when they fall sick,” consisted of 2 items with a reliability coefficient of 0.42. In order to achieve balance, mothers employed strategies to gain the cooperation and understanding of those in the environment, and coordinated and consulted with those at home and work on a daily basis in the context of the local community. Given these strategies, we conclude that mothers who balance work and child-rearing plan for and use a variety of resources. Conclusion: As strategies to achieve balance between work and child rearing, the mothers of preschool children made efforts to connect with their local communities as they allotted and coordinated household duties. In addition, they consulted and coordinated with others in their workplaces.
2-196-P The factors affecting repeat induced abortion in women of
childbearing age in China: A review
Yue Tian, Qiuxing Chen, Yuliang Zou, Ruihua Hu, Lishi Yin school of Public health, University of Wuhan Objective: To study factors affecting repeat induced abortion in women of childbearing age in China, and to put forward suggestions to reduce repeat induced abortion rate in China. Method: This article proposes an influential ecological model for health promotion to review these factors. Result: we reviewed factors affecting repeat induced abortion in women of childbearing age at five levels: the intrapersonal level, the interpersonal level, the institutional level, the community level, and the public policy level. Besides, by reviewing these factors, we found that policymakers and researchers could complete comprehensive intervention to reduce repeat induced abortion rate with the direction of ecological model for health promotion. Conclusion: By reviewing factors affecting repeat induced abortion in women of childbearing age with ecological model for health promotion, we found that high repeat induced abortion rate in China was affected not only by intrapersonal factors, but also by the interpersonal factors, institutional factors, community and public policy. Therefore, in order to lower the repeat induced abortion rate, women of childbearing age should strengthen contraception consciousness and enhance the skills to protect their reproductive health. In addition, governments and public should cooperate to promote the reproductive health awareness and establish social protective barriers for women’s reproductive health. Especially, government should formulate proper reproductive policy and provide the economic guarantee to population development.
252
2-197-P Past history of snakebite among Chronic Kidney Disease of
unknown origin among patients in Sri Lanka: a case control study
Buddhika Thilanga Bandara Wijerathne 1, Robert John Meier 2, Sujatha Salgado 3, Geetha Kumari Rathnayake 4, Anushitha Dayasiri 5, Suneth Buddhika Agampodi 1 Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Department of Anthropology, Indiana University, Bloomington, United States of America, 3 Department of Anatomy, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka, 4 Primary Medical Care Unt Kendewa, RDHS Anuradhapura, Anuradhapura, Sri Lanka, 5 Department of Forensic Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka 1 2
Objectives Chronic Kidney Disease of unknown etiology (CKDu) is the leading public health problem in North Central Province (NCP) of Sri Lanka. The current definition of CKDu includes a history of snake bite as an exclusion criterion. Not all snakebites cause kidney damage, as there are non-venomous snakes. The aim of this study was to evaluate the history of snakebite among CKDu patients in an CKDu-endemic region (CKDu-ER) and compare it with non- Chronic Kidney Disease (N-CKD) patients from the same region as well as from the CKDu non-endemic region (CKDu-NER) Methods A case control study was conducted. Consented patients were recruited from renal clinics in CKDu endemic region. Two control groups (N-CKD) were selected from CKDu-ER and CKDu-NER. A past history of snakebite was obtained from all participants. Expert did not authenticate the offending snakes as we obtained data from patient recall. Results 212 CKDu patients were interviewed and sex ratio was M:F = 1:0.5. The mean age for cases was 58.09 (± 7.34 Standard Deviation (SD)). 110 people were selected from CKDu-NER and sex ratio was 1:1 while mean age was 51.57 ± 7.21SD. 119 people selected from CKDu-ER and sex ratio was 1:1 whilst mean age was 53.28 ± 7.95. History of snakebite was evident in 22.2% of CKDu patients compared to 8.2% in CKDu-NER and 16.0% in CKDu-ER. After adjustment for sex and age, the comparative analysis of history of snakebite in CKDu patient and CKDu-NER did not show significant differences (P=0.527, odds ratio (OR)=1.2 (95% CI 0.7 to 2.3)). However when history of snakebite in cases compared with CKDu-ER showed statistically significant difference (P=0.032, OR = 162.8 (95% CI 1.6 to 16926.4)). Conclusion Despite recall bias and lack of authentication by a snakebite expert, current findings suggest that history of snakebite was a significant risk factor among people residing in CKD endemic region compared to CKD non-endemic region.
2-198-P Association between Japan’s nurse staffing standards in fee-
schedule and geographic distribution of hospital nurse density
Noriko Morioka 1, Jun Tomio 1, Toshikazu Seto 2, Yasuki Kobayashi 1 Department of Public Health, The University of Tokyo, 2 Center for Spatial Information Science, The University of Tokyo
1
Objectives: In Japan, the fee-schedules differ among different functional categories of inpatient wards, and the reimbursement was higher for the ward with higher nurse staffing ratios. The influence of the change of fee-schedule regarding the nurse staffing ratios on the geographic distribution of hospital nurse was not clear. We aimed 1) to investigate the association between the densities of hospital beds by functional category of inpatient wards and the hospital nurse density, and 2) to investigate the association between those densities of hospital beds and the actual-to-required nurse ratio. Methods: We conducted secondary data analysis of the cross sectional data from hospitals reports about basic hospitalization charges and other multiple data sources disclosed by the Ministry of Health, Labour and Welfare. We used Secondary Medical Areas (SMAs) in Japan as study units. The outcome variables were nurse density per 100,000 populations and actual-torequired nurse ratio (%) in SMA. We considered the densities of hospital beds per 100,000 population by functional categories as explanatory variables: Intensive-Care unit (ICU); 7:1 inpatient-to-nurse ratio ward (7:1); Long-Term Care ward (LTC) and so on. Multivariable multilevel regression analysis was conducted for nurse density, taking into account for the possible confounders. Multivariable regression analysis was conducted for actual nurse-to-required nurse ratio. Results: Means (standard deviations) of the nurse density and the actual-to-required nurse ratio were 548.8(183.1) and 134.7% (31.1%) among 343 SMAs, respectively. After adjusting for the possible confounders, the nurse densities were likely to be higher in the SMAs with higher the ICU beds density (regression coefficient (coef): 3.41, 95% confidence interval (CI): 2.68, 4.13), higher the 7:1 bed density (coef: 0.46, 95% CI: 0.39, 0.53), lower the LTC bed density (coef: -0.14, 95% CI: -0.24, -0.05). The actual-to-required nurse ratios were likely to be higher in the SMAs with higher the ICU beds density (standardization coefficient: 0.14, p
