The Relationship between Exposure to Anti-Smoking Campaign, Knowledge, Family Support, and Smoking Habit, Among Male Workers in East Borneo, Indonesia

BACKGROUND: Indonesia has the highest (46.16%) prevalence of smokers among the ASEAN countries. Some anti-smoking measures had been implemented. However, little was known for their effect. This study aimed to determine the prevalence of smoking, and the relationship between exposure to anti-smoking campaign, knowledge, family support, and smoking habit, among male workers in East Borneo, Indonesia. SUBJECT AND METHODS: This was a cross sectional study conducted in Samarinda, East Borneo, Indonesia. A sample of 311 male workers was selected at random from 10 subdistrics in Samarinda. The dependent variable was smoking behavior. The independent variable included exposure the anti-smoking campaign, knowledge about the damaging effect of tobacco smoking, and family support. A structured questionnare was developed to collect the data. A logistic regresion was used to analyze the data. RESULTS: The prevalence of smokers was 45.6% (95%CI=40.09 to 51.23). Un-exposure to anti-smoking campaign (OR=2.24, 95%CI= 1.10 to 4.68; p=0.032), lacking in knowledge of the health damaging effect of tobacco smoking such as mouth and throat cancers (OR=2.43; 95%CI=1.16 to 5.06; p=0.018), and weak family support (OR= 2.07; 95%CI=1.09 to 4.50; p=0.006), were all associated with an increased probability of smoking. CONCLUSION: Nearly half of the Indonesian male workers living in Samarinda were smokers. Un-exposure to anti-smoking campaign, lacking in knowledge of the health damaging effect of tobacco smoking such as mouth and throat cancers, and weak family support, were all associated with an increased probability of smoking. The government should increase the frequency of anti-smoking campaign and improve its access. Keywords: anti-smoking campaign, smoking behavior, male worker

Perceived Health Service, Quality of Care, and Multidrug Resistent Tuberculosis: A Case-Control Study in Central Java, Indonesia

Background: Tuberculosis (TB) remains a leading cause of morbidity and mortality in developing countries, including Indonesia. Drug resistance, in combination with other factors, results in even more increased morbidity and mortality due to tuberculosis. Globally, there were about 0.5 million cases of multidrug resistant tuberculosis (MDR-TB). The WHO reported an alarming rise of not only MDR-TB but also of extreme drug-resistant tuberculosis (XDR-TB) globally. This study aimed to determine the associations of perceived health care behavior and perceived quality of care with MDR-TB in Central Java, Indonesia. Subjects and Method: This was a case-control study conducted in Surakarta, Central Java, Indonesia, from August 2017 to January 2018. A sample of 309 subjects was selected for this study, consisting of 81 MDR-TB cases and 228 non MDR-TB controls. The dependent variable was MDR-TB. The independent variables were perceived health provider behavior and perceived quality of care. MDR-TB data were obtained from medical record. The other variables were collected by questionnaire. The data were analyzed by a multiple logistic regression. Results: The risk of MDR-TB increased with unfavorable perceived provider behavior (OR= 2.80; 95% CI= 1.64 to 5.09; p<0.001) and perceived poor quality of health service (OR= 1.90; 95% CI= 1.15 to 3.37; p= 0.013) received by the patients. Conclusion: The risk of MDR-TB is associated with unfavorable perceived provider behavior and perceived poor quality of health service received by the patients. Keywords: perceived provider behavior, perceived quality of health service, MDR-T

Health care utilisation under the 30-Baht Scheme among the urban poor in Mitrapap slum, Khon Kaen, Thailand: a cross-sectional study

Background: In 2001, the Government of Thailand introduced a universal coverage scheme with the aim of ensuring equitable health care access for even the poorest citizens. For a flat user fee of 30 Baht per consultation, or for free for those falling into exemption categories, every scheme participant may access registered health services. The exemption categories include children under 12 years of age, senior citizens aged 60 years and over, the very poor, and volunteer health workers. The functioning of these exemption mechanisms and the effect of the scheme on health service utilisation among the poor is controversial. Methods: This cross-sectional study investigated the prevalence of 30-Baht Scheme registration and subsequent self-reported health service utilisation among an urban poor population in the Teparuk community within the Mitrapap slum in Khon Kaen city, northeastern Thailand. Furthermore, the effectiveness of the exemption mechanisms in reaching the very poor and the elderly was examined. Factors for users' choice of health facilities were identified. Results: Overall, the proportion of the Teparuk community enrolled with the 30-Baht Scheme was high at 86%, with over one quarter of these exempted from paying the consultation fee. User fee exemption was significantly more frequent among households with an above-poverty-line income (64.7%) compared to those below the poverty line (35.3%), χ2 (df) = 5.251 (1); p-value = 0.018. In addition, one third of respondents over 60 years of age were found to be still paying user fees. Self-reported use of registered medical facilities in case of illness was stated to be predominantly due to the service being available through the scheme, with service quality not a chief consideration. Overall consumer satisfaction was high, especially among those not required to pay the 30 Baht user fee. Conclusion: Whilst the 30-Baht Scheme seems to cover most of the poor population of Mitrapap slum in Khon Kaen, the user fee exemption mechanism only works partially with regard to reaching the poorest and exempting senior citizens. Service utilisation and satisfaction are highest amongst those who are fee-exempt. Service quality was not an important factor influencing choice of health facility. Ways should be sought to improve the effectiveness of the current exemption mechanisms.Sophie Coronini-Cronberg, Wongsa Laohasiriwong and Christian A Gerick

Ultrafine grained plates of Al-Mg-Si alloy obtained by Incremental Equal Channel Angular Pressing : microstructure and mechanical properties

In this study, an Al-Mg-Si alloy was processed using via Incremental Equal Channel Angular Pressing (I-ECAP) in order to obtain homogenous, ultrafine grained plates with low anisotropy of the mechanical properties. This was the first attempt to process an Al-Mg-Si alloy using this technique. Samples in the form of 3 mm-thick square plates were subjected to I-ECAP with the 90˚ rotation around the axis normal to the surface of the plate between passes. Samples were investigated first in their initial state, then after a single pass of I-ECAP and finally after four such passes. Analyses of the microstructure and mechanical properties demonstrated that the I-ECAP method can be successfully applied in Al-Mg-Si alloys. The average grain size decreased from 15 - 19 µm in the initial state to below 1 µm after four I-ECAP passes. The fraction of high angle grain boundaries in the sample subjected to four I-ECAP passes lay within 53-57 % depending on the examined plane. The mechanism of grain refinement in Al-Mg-Si alloy was found to be distinctly different from that in pure aluminium with the grain rotation being more prominent than the grain subdivision, which was attributed to lower stacking fault energy and the reduced mobility of dislocations in the alloy. The ultimate tensile strength increased more than twice, whereas the yield strength - more than threefold. Additionally, the plates processed by I-ECAP exhibited low anisotropy of mechanical properties (in plane and across the thickness) in comparison to other SPD processing methods, which makes them attractive for further processing and applications

Varying coefficient panel data models and methods under correlated error components: Application to disparities in mental health services in England

The contribution of this paper is twofold. Firstly, it introduces novel regression models that combine two important areas of the methodological development in panel data analysis, namely a varying coefficient specification and spatial error dependence. The former allows relatively flexible nonlinear interactions; the latter enables spatial correlations of the disturbance and thus differ significantly from the other random effect models in the literature. To estimate the model, a new estimation procedure is established that can be viewed as a generalization of the quasi-maximum likelihood method for a spatial panel data model to the well-known conditional local likelihood procedure. Novel inference methods, particularly variable selection and hypothesis testing of the parameter constancy, are introduced and are shown to be effective under the complex spatial error dependence. Equally importantly, this paper makes a substantial contribution to the understanding of financing and expenditure for health and social care. In particular, we empirically analyze and explain the effects of political ideologies on the local fiscal policy in England, especially the expenditure on mental health services