Steroid Hormones and Endocrine Disruptors: Recent Advances in Receptor–Mediated Actions

It has been accepted that receptor-mediated action of steroid hormones depends on both the receptor and the hormonal level. The mechanism of transcription by steroid receptors is mediated by cofactors, which function as co-activators or co-repressors, while their non-genomic actions depend on receptors localized to the cell membrane. Recently, a number of environmental chemicals, which are now termed as endocrine disruptors, have been identified, and their unwanted effects on our lives have become serious problems all over the world. Their adverse effects on endocrine systems in animals, mostly estrogenic or anti-estrogenic, have resulted in reproductive malfunction and developmental disorders. Although aryl hydrocarbons exhibit estrogenic or anti- estrogenic activity through specific interaction with aryl hydrocarbon receptors, other chemicals seem to interact directly with estrogen receptors, α and β forms. In this paper, we surveyed the most recent understanding of endocrine disruptors from the viewpoint of steroid receptor systems. We suggest two potential mechanisms of action for endocrine disruptors. Endocrine distruptors i) directly associate with steroid receptor systems and/or ii) associate with the growth factor or the neurotransmitter receptor systems, and then upregulate the mitogen-activated protein kinase signaling cascades, leading to the ligand-independent activation of steroid receptor systems. Using these steroid receptor-dependent mechanisms, it appears that endocrine disruptors disorder our endocrine systems. We have proposed future suggestions to further understand endocrine disruptors from the viewpoint of steroid receptor systems. Key words: endocrine disruptors; receptor-mediated actions; steroid hormone

Steroid Hormones and Endocrine Disruptors: Recent Advances in Receptor–Mediated Actions

It has been accepted that receptor-mediated action of steroid hormones depends on both the receptor and the hormonal level. The mechanism of transcription by steroid receptors is mediated by cofactors, which function as co-activators or co-repressors, while their non-genomic actions depend on receptors localized to the cell membrane. Recently, a number of environmental chemicals, which are now termed as endocrine disruptors, have been identified, and their unwanted effects on our lives have become serious problems all over the world. Their adverse effects on endocrine systems in animals, mostly estrogenic or anti-estrogenic, have resulted in reproductive malfunction and developmental disorders. Although aryl hydrocarbons exhibit estrogenic or anti- estrogenic activity through specific interaction with aryl hydrocarbon receptors, other chemicals seem to interact directly with estrogen receptors, α and β forms. In this paper, we surveyed the most recent understanding of endocrine disruptors from the viewpoint of steroid receptor systems. We suggest two potential mechanisms of action for endocrine disruptors. Endocrine distruptors i) directly associate with steroid receptor systems and/or ii) associate with the growth factor or the neurotransmitter receptor systems, and then upregulate the mitogen-activated protein kinase signaling cascades, leading to the ligand-independent activation of steroid receptor systems. Using these steroid receptor-dependent mechanisms, it appears that endocrine disruptors disorder our endocrine systems. We have proposed future suggestions to further understand endocrine disruptors from the viewpoint of steroid receptor systems. Key words: endocrine disruptors; receptor-mediated actions; steroid hormone

A case-control study related to vitamin and mineral intake in female adolescents with iron deficiency anemia

Latar belakang: Anemia defisensi besi (ADB) merupakan salah satu masalah nutrisi pada remaja putri di seluruh dunia. Penyerapan zat besi di usus halus dipengaruhi oleh adanya vitamin C, kalsium, dan zink pada makanan. Penelitian ini bertujuan untuk mengetahui hubungan pola konsumsi vitamin A, vitamin C, kalsium dan zink terhadap kejadian ADB pada remaja putri. Metode: Penelitian ini merupakan penelitian case control yang melibatkan 60 remaja putri dengan ADB dan 58 remaja putri tanpa ADB. Diagnosis ADB berdasarkan kadar Hb dan indeks eritrosit, dan semikuantitatif FFQ digunakan untuk menentukan asupan vitamin dan mineral. Semua data dianalisis menggunakan test chi square dan tes regresi logistik ganda dengan p<0.05. Hasil: Semua subjek penelitian mempunyai asupan vitamin A dan C harian yang cukup tetapi asupan kalsium dan zinknya tergolong kurang (dalam mg). Namun, mereka semua memiliki frekuensi harian yang berbeda dalam mengkonsumsi mikronutrien tersebut. Remaja putri dengan asupan vitamin A yang jarang (OR=2.67; CI95%=1.10-6.50; p=0.03) dan asupan kalsium yang sering (OR=2.27; CI95%=0.85-6.03; p=0.10) lebih berisiko terkena ADB dibandingkan dengan remaja putri dengan asupan vitamin A yang sering dan asupan kalsium yang jarang. Akan tetapi hanya asupan vitamin A yang memiliki efek signifikan secara statistik. Kesimpulan: Hasil penelitian ini menunjukkan bahwa tingginya risiko ADB pada remaja putri berkaitan dengan asupan vitamin A yang jarang. Kata kunci: anemia defisiensi besi, asupan mikronutrien, remaja putri   Abstract Background: Iron deficiency anemia (IDA) is a nutritional problem that occurs in female adolescents around the world. Iron absorption in the small intestine is influenced by the presence of vitamin C, calcium, and zinc in ingested foods. This study aimed to investigate the relationship of vitamin A, vitamin C, calcium, and zinc intake with IDA in female adolescents. Methods: This case-control study was conducted in 60 anemic and 58 normal female adolescents. IDA diagnosis was determined using Hb levels and erythrocyte indexes and the semiquantitative food frequency questionnaire was used to determine vitamin and mineral intake. All collected data were analyzed using chisquare and multiple logistic regression tests with p<0.05. Results: All groups had an adequate intake of vitamin A and C but they had inadequate intake of calcium and zinc (in mg). However, they all had different frequencies in consuming those micronutrients. Rare intake of vitamin A (OR=2.67; CI95%=1.10-6.50; p=0.03) and frequent intake of calcium (OR=2.27; CI95%=0.85- 6.03; p=0.10) increased IDA, compared with frequent intake of vitamin A and rare intake of calcium but only vitamin A intake had a significant effect. Conclusion: Our findings suggest that a higher risk of IDA in female adolescents is related to a rare intake of vitamin A. Keywords: Iron deficiency anemia; micronutrient intake; female adolescent

Evaluation of “Jumat Pintar” Program in Reducing the Incidence of Anemia in Young Women in Sukoharjo, Indonesia

Background: Anemia is iron deficiency in the body which gives a negative impact. Anemia in the short term can lead to vulnerable young women experience a decline in achievement of learning at school. While long-term, sustained anemia from adolescence until the pregnant can lead to complications of bleeding to death and in Sukoharjo, Jumat Pintar implementation prevents the incidence anemia especially in young women. The activity encouraged from this policy is the giving of Fe tablet. The evaluation was conducted to assess the performance of the implementation of the policy of running and achievements obtained in accordance with the original purpose. This study was aimed to evaluate the implementation of Jumat Pintar program in lowering the incidence of anemia of young women.Subject and Methods: This was a qualitative study, was conducted in September-October 2016 in Sukoharjo. A total of 20 samples were selected by using purposive sampling technique. The data was collected using in depth interviews, observation and study of documentation. The data were analyzed using the interactive analysis techniques to compare the data obtained with data triangulation.Results: The execution of Jumat Pintar at stages of planning activities, the determination of the amount of goals and services granting Fe tablet was in adherence with the standard procedures of implementation. The stage of the expansion of the network of independent outlets and stages of monitoring and oversight have not run optimally. The scope of consumption of Fe tablet is not can be traced and decrease in the numbers of Genesis anemia in teenagers does not represent the entire area. The main constraints implementation comes from the absence of a legal umbrella agreement work, lack of financial support from various parties, the low commitment of the education sector, and low awareness of the goal.Conclusion: The implementation of Jumat Pintar is running optimally. The formation of independent outlets have yet to be implemented at each high school in Sukoharjo Regency, the absence of funding sources and still low level of involvement of target.Keywords: anemia, the movement of young women, the evaluation of the implementation of Jumat Pintar program.Correspondence: Ayudhia Pratiwi. School of Public Health, Sebelas Maret University, Surakarta.Journal of Maternal and Child Health (2016), 1(1): 25-33https://doi.org/10.26911/thejmch.2016.01.01.05

Knowledge, Attitude, Sexual Behavior, Family Support, and Their Associations with HIV/AIDS Status in Housewives

Background: Approximately 36.7 million people in the world were infected by HIV and 2.1 million new cases occured in 2015. A total of 191,073 HIV cases were reported in Indonesia in 2016, including 77,940 AIDS cases, and 13,247 deaths. Housewives ranked highest among HIV/AIDS patients in Indonesia. This study aimed to investigate knowledge, attitude, sexual behavior, family support, and their associations with HIV status in housewives using PRECEDE PROCEED model.Subjects and Method: This was an analytic observational study with cross-sectional design. The study was conducted at Toroh community health center, Grobogan, Central Java, in July, 2017. A total sample of 129 housewives were selected for this study using exhaustive sampling technique. The dependent variable was HIV status. The independent variables were knowledge, attitude, sexual behavior, and family support. The data was measured by a set of questionnaire and analyzed using path analysis.Results: HIV status was directly and positively associated with risky sexual behavior (b= 4.48; 95% CI= 2.30 to 6.65; p<0.001). Risky sexual behavior was associated with attitude (b= -1.27; 95% CI = -0.03 to -2.51; p<0.045) and family support (b= -1.86; 95% CI= -0.69 to -3.03; p<0.002). Attitude was associated with knowledge (b= 2.06; 95% CI = 0.86 to 3.25; p<0.001).Conclusion: HIV status is directly and positively associated with risky sexual behavior. HIV status is indirectly associated with attitude, knowledge, and family support.Keywords: HIV, AIDS, risky sexual behavior, housewives, PRECEDE PROCEED modelCorrespondence: Budi Laksana. Diploma III Program in Midwifery Muhammadiyah, Madiun, East Java. Email: [email protected]. Mobile: +6285655612000.Journal of Epidemiology and Public Health (2017), 2(2): 154-163https://doi.org/10.26911/jepublichealth.2017.02.02.0

Analysis of Factors Associated with Anemia in Pregnant Women at Prambanan Community Health Center, Sleman, Yogyakarta

Background: Maternal anemia has serious impact on maternal and fetal health outcome. Pregnant women are at high risk of anemia. This study aimed to investigate the factors associated with the incidence of anemia among pregnant women.Subjects and Method: This was an analytic and observational study with cross-sectional design. This study was conducted at Prambanan Community Health Center, Sleman, Yogyakarta. A total of 120 trimester II and III pregnant mothers, was selected for this study. The dependent variable was incidence of anemia. The independent variables were gestational age and maternal education. The data were collected by a questionnaire and analyzed by multiple logistic regression.Result: Trimester II pregnant women had lower risk of anemia than trimester III (OR = 0.35; 95% CI = 0.15 to 0.80; p = 0.013). Pregnant women completed high school had lower risk of anemia than lower education (OR = 0.33; 95% CI 1.29 to = 6.81; p = 0.010).Conclusion: Gestational age and maternal education are associated with the risk of anemia in pregnant women.Keywords: anemia, pregnant women, trimester II and III, maternal educationCorrespondence: Ratna Prahesti. Masters Program in Public Health, Sebelas Maret University, Surakarta.Journal Maternal and Child Health, 2016; 1(2): 131-137    https://doi.org/10.26911/thejmch.2016.01.02.0

Association betweenMaternal Age at Pregnancy, Socioeconomic Status, Physical Environment, Prenatal, Perinatal, Postnatal History, and the Risk of Mental Retardation

Background: Mental retardation (MR) is a serious public health problem for an country. The prevalence of mental retardation in Indonesia was estimated at 1-3% of the population. About 0.1% of whichneed treatment and guidance the whole life. This study aimed to determine the association between maternal age at pregnancy, socioeconomic status, physical environment, prenatal, perinatal, postnatal history, and mental retardation.Subject and methods: This was an analytic observational study with case control design. This study was conducted in Pare, Kediri, East Java, Indonesia,from October to December 2016. A total 105 study subjects, consisting of 35 MR cases and 70 controls were selected for this study by fixed disease sampling. The independent variables were maternal age at pregnancy, socioeconomic status, physical environment, prenatal, perinatal, and postnatal history. The dependent variable was mental retardation. The data were collected by questionnaire and analyzed by logistic regression model.Results: Maternal age ≥35 years at pregnancy was associated with an increased risk of MR, and it was statistically significant The result showed that mother’s age while pregnant (OR=10.18; 95%CI=2.77 to 37.39; p<0.001). High socioeconomic status (OR=0.23;95%CI=0.07 to 0.81; p=0.022), good physical environment (OR=0.13; 95%CI=0.04 to 0.45; p=<0.001), good prenatal history (OR=0.24;95%CI=0.07 to 0.82; p=0.022), good perinatal history (OR=0.45;95%CI=0.15 to 1.40; p=0.168), good postnatal (OR=0.43;95%CI=0.14 to 1.35; p=0.148), were associated with a decreased risk of MR. Nagelkerke R2=53.8% for this model.Conclusion: Maternal age ≥35 years at pregnancy increases the risk of MR. High socioeconomic status, good physical environment, good prenatal, perinatal, and postnatal history, decrease the risk of MR.Keywords: mental retardation, maternal age at pregnancy, socioeconomic status, environment, pregnancy history.Correspondence: Erna Nurochim. Masters Program in Public Health, Sebelas Maret University, Surakarta.Journal of Maternal and Child Health (2016), 1(2): 119-130https://doi.org/10.26911/thejmch.2016.01.02.0

Path Analysis on the Associations between Infertility, Stress, and Depression among Women in Surakarta, Central Java

Background: In patriarchal societies like Indonesia, infertility is culturally considered as a problem of women. Most of the burden of infertility is borne by women because of a rapid decline in fertility with age, societal pressure and stigma. Infertility can affect psychological disorders such as stress and depression. This study aimed to examine the associations between infertility, stress, and depression among women in Surakarta, Central Java.Subjects and Method: This was  an analytic observational study with a cross sectional design. It was conducted in Surakarta, Central Java, from September to October 2018. A sample of 200 women of reproductive age was selected by fixed exposure sampling. The dependent variable was depression. The independent variables were social support, coping strategy, self-efficacy, infertility, and stress. Data on infertility was obtained from medical record. The other data were collected by questionnaire. The data were analyzed by path analysis.Results: The likelihood of depression among women was directly increased by stress (b= 2.09; 95% CI= 1.31 to 2.87; p<0.001) but decreased by good coping strategy (b= -1.57; 95% CI = -2.34 to -0.80; p <0.001). It was indirectly affected by infertility, self-efficacy, and social support. Conclusions: Depression is directly increased by stress but decreased by good coping strategy. It is indirectly affected by infertility, self-efficacy, and social support.Keywords: depression, stress, infertility, path analysis, women of reproductive ageCorrespondence: Yesi Retiyansa. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami No. 36 A, Surakarta 57126, Central Java. Email:[email protected]. Mobile: +6281252634625.Journal of Maternal and Child Health (2019), 4(4): 260-266https://doi.org/10.26911/thejmch.2019.04.04.05

Gender, Diet, and Metabolic Syndrome in Adolescents in Malang, East Java

BACKGROUND: Metabolic syndrome is a set of sympton causing degenerative disease. Metabolic syndrome is assesed based on individual body mass index, waist circumference, blood presure, triglyceride level, high density lipoprotein level, and fasting blood sugar level. People with overweight and obesity had an increased risk of metabolic syndrome. This study aimed to examine the relationship between gender, diet, and metabolic syndrome, in adolescents. SUBJECT AND METHODS: This was a cross sectional study conducted in Malang, East Java. A sample of 227 adolescents was selected from several high school in Malang. The dependent variable was metabolic syndrome. The independent variables were gender and diet, which included energy, carbohydrate, protein, and fat intake. The data were analyzed using linear regression. RESULT: There were positive and statistically significant relationships between metabolic syndrome and energy intake (b=0.01; 95%CI=0.009 to 0.02; p=0.026); carbohydrates intake (b=0.02, 95%CI=0.01 to 0.04; p=0.012); protein intake (b=0.07; 95%CI=0.03 to 0.09; p=0.010); fat intake (b=0.06; 95%CI=0.04 to 0.12; p=0.002), gender (b=1.81; 95%CI=0.08 to 3.52; p=0.039). CONCLUSION: Diet and gender are risk factors for metabolic syndrome. Keywords: metabolic syndrome, gender, die

Qualitative Analysis on the Factors Affecting Exclusive Breastfeeding among Working Mothers at Community Health Center in Bangkalan, Madura

Background: Exclusive breast milk is the main food for infants aged 0-6 months. Breast feeding can be extended up to 2 years with complementary food. The prevalence of exclusive breast feeding is targeted to exceed 80%. Study have shown some factors may determine exclusive breastfeeding among working mothers, such as desire to return to work soon after giving birth, distance from home to the workplace, and supporting facilities (e.g. space, freezer) at the workplace. This study aimed to investigate factors affecting exclusive breast feeding among working mother at the workplace.Subjects and Method: This was a qualitative study with phenomenology approach. This study was conducted at the Community Health Center, Bangkalan, Madura. A total of 9 working mothers were purposively selected as informants. The administrators at the workplace were interviewed as another source of information. Some family members were also selected as informants. The data were collected by interview, observation, taking photos, and document review (e.g. maternal and child health book).Results: Exclusive breastfeeding was associated with workplace support for breastfeeding. Adequacy of breastfeeding facility at the workplace was described by mothers as having a place allocated for expressing breast milk and provision of flexible time to express breast milk other than the usual rest time. Most of mothers who were interviewed breastfed their babies for less than three months. Mothers who worked in workplaces that did not provide breastfeeding rooms and refrigerators were more likely to discontinue breastfeeding. Lack of flexible time to express breast milk was also associated with breastfeeding discontinuation. The existence of policies breastfeeding leave, arrangement for light duty after delivery, and flexible working hours, were associated with breastfeeding.Conclusion: Provision of adequate breastfeeding facilities at the workplace, such as a room in which to express breast milk, and a refrigerator, as well as the existence of policy that allows mothers to have flexible time to express breast milk, are important determinants for exclusive breast feeding among employed mothers.Keywords: exclusive breast feeding, working mothers, workplace Correspondence: Dwi Wahyuning Tiyas. Masters Program in Public Health, Sebelas Maret UniversityJournal of Maternal and Child Health (2016), 1(2): 110-118https://doi.org/10.26911/thejmch.2016.01.02.0