Faktor Determinan Keluhan Infeksi Menular Seksual pada Pekerja Seks Perempuan di Kecamatan Tabanan Tahun 2012

Infeksi menular seksual (IMS) di Bali masih merupakan satu permasalahan kesehatan. Di Tabanan, terjadi peningkatan jumlah kasus IMS sebesar 50% dari tahun 2010 ke tahun 2011, sebagian besar dialami oleh pekerja seks perempuan (PSP). Penelitian ini bertujuan untuk mengekplorasi faktorfaktor determinanyang mempengaruhi terjadinya IMS pada PSP. Penelitian ini merupakan penelitain analitik potong lintang. Sebanyak 86 responden dilibatkan dalam penelitian yang terdiri dari 29 PSP langsung dan 57 PSP tidak langsung, responden dipilih dengan menggunakan metode stratified random sampling. Data dikumpulkan dengan wawancara langsung menggunakan kuesioner, kemudian data dianalisis secara deskriptif, dengan uji chi square dan regresi logistik. Hasil penelitian menunjukkan penggunaan kondom berpengaruh secara bermakna terhadap riwayat keluhan IMS (OR=9,95% CI=1,34-60,39), dan faktor dukungan sosial juga berpengaruh bermakna (OR=9,95% CI=2,52-32,14). Variabel lain yang juga berpengaruh dalam analisis bivariat adalah sikap negative terhadap pencegahan IMS (p=0,018), akses terhadap kondom (p=0,007), akses ke layanan kesehatan (p=0,016), dan pencucian vagina (p=0,033). Penggunaan kondom dan dukungan sosial merupakan faktor utama yang mempengaruhi riwayat keluhan IMS. Sehingga untuk menurunkan prevalensi IMS, akses terhadap kondom harus ditingkatkan, perlunya upaya mobile screening, serta pemberian layanan dan informasi yang komprehensif seputar kesehatan reproduksi. Disamping itu pembentukan kelompok dukungan serta kerjasama dengan manajer kafe dan mucikari diperlukan untuk mendorong upaya penggunaan kondom dan pemeriksaan kesehatan yang rutin

Unlinked Anonymous Seroprevalen Survey HIV pada Ibu Hamil dan Perilaku Berisiko Terkait di Kabupaten Klungkung, Bali Tahun 2011

HIV dan AIDS di Provinsi Bali menduduki prevalensi kedua di Indonesia. Pekerja seksperempuan (PSP) merupakan kelompok berisiko dengan prevalensi HIV yang cukup tinggi dansangat berpotensi menularkan HIV ke pelanggannya, yang selanjutnya berisiko terjadi penularandari pelanggan ke pasangannya. Hasil studi yang melibatkan bidan praktek swasta di Denpasarmenunjukkan persentase HIV pada ibu hamil sebesar 1,2%. Di Kabupaten Klungkung cukupbanyak dijumpai café serta lokasi yang memungkinkan sebagai tempat transaksi seksual antaraPSP dan pelanggan, dan belum pernah dilakukan eksplorasi terhadap prevalensi HIV padaibu hamil. Oleh karena itu penting untuk mengetahui kejadian HIV/AIDS pada ibu hamil diKabupaten Klungkung.Penelitian ini merupakan penelitian survei potong lintang yang bersifat anonymous (unlinkedanonymous survey) dengan populasi penelitian adalah semua ibu hamil di Kabupaten Klungkung,dan populasi terjangkau adalah ibu hamil yang melakukan ANC ke puskesmas. Jumlah sampelminimal pada penelitian 230 orang, yang dihitung berdasarkan asumsi prevalensi HIV pada ibuhamil (p=1,2%), tingkat kepercayaan 95% (?=5%), dan margin of error =1%. Data yang dikumpulkanmeliputi karakteristik, riwayat kehamilan dan riwayat perilaku berisiko dan status HIV. StatusHIV ditentukan berdasarkan hasil pemeriksaan dari di Balai Lab Kesehatan Provinsi Bali. Datadianalisis secara deskriptif menggunakan perangkat statistik.Ibu hamil rata-rata berusia 28 tahun, dengan pendidikan terbanyak adalah SMP dan SMA,sebanyak 58,7% merupakan kehamilan I dan II. Tidak ada ibu hamil yang HIV+, sehinggaprevalensi HIV pada ibu hamil ditemukan sebesar 0%. Riwayat paparan terhadap risikopenularan IMS termasuk HIV&AIDS ditemukan pada 23,3% ibu hamil, yang terbanyak adalahriwayat keluhan infeksi menular seksual dan riwayat suami bekerja di luar kota.Dari penelitian dapat dilihat prevalensi HIV pada ibu hamil sebesar 0%, namun cukup banyakyang memiliki riwayat perilaku/paparan risiko. Rekomendasi untuk pihak terkait agar bisamelakukan pemantauan prevalensi HIV pada ibu hamil dengan mengembangkan programpencegahan penularan dari ibu ke anak (PMTCT

Employment and Education as Risk Factors of Cataract Incidence on Patients Treated in Eye Health Centre Mataram City West Nusa Tenggara

Background and purpose: The purpose of the study was to determine the risk factors of employment, education and other risk factors on the occurrence of cataracts in patients seeking treatment at Eye Health Center in the City of Mataram, West Nusa Tenggara.Methods: The study was a case-control with a sample of cases and controls, respectively amounted to 40 (1: 1). The dependent variable was the incidence of cataract and independent variables were: education, employment, income, diabetes mellitus, history of cataracts, smoking behavior, and exposure to smoke and sun exposure. Data were collected by means of interviews using questionnaires and tracking documents of patients' medical records. Data analysis was performed using univariate, bivariate to determine the comparability between cases and controls and tosee the crude of OR. Multivariate analyses were performed to determine the adjusted OR.Results: Four variables were found to be risk factors to the occurrence of cataracts: education, income, occupation and exposure to sunlight with each crude OR of 10.50 (95% CI: 3.39 to 32.52); 6.23 (95% CI: 2.35 to 16.51), 10.52 (95%CI: 3.56 to 31.12); and 3.11 (95% CI: 1.25 to 7.78). While diabetes mellitus, history of cataracts, smoking behavior and exposure to smoke was not statistically proven as a risk factor for cataracts. The multivariate analysis showed that most risk factors played a role in the occurrence of cataract was employment with OR=9.81 (95% CI: 1.85 to 52.02) and education with OR=6.53 (95% CI: 1.42 to 29.92).Conclusion: Employment and education were significant risk factors to the occurrence of cataracts in patients who visited the Eye Health Center in the City of Mataram, West Nusa Tenggara

Defisiensi mikronutrien pada anak usia 12-59 bulan di Desa Lebih, Kabupaten Gianyar, Bali

Deficiency of micronutrients in children of age 12-59 months in Lebih Village, Gianyar District, BaliBackground: Lack of food intake, either in quantity or quality, will continuously cause children to get sick easily, such as being susceptible to infectious diseases and ultimately inhibiting the children’s growth.Objective: This study aimed to describe the status of micronutrients (zinc and iodine) and anemia status among children aged 12-59 months in Lebih Village. Methods: This analytic observational study used a cross-sectional design conducted in Lebih Village, Gianyar Regency. The study population was all children under five aged 12-59 months. In addition, 91 children under five were selected as research subjects using the probability proportional to size method. The data collected were the identity of the subjects (children under five and their mothers) using the interview method, serum zinc levels, urinary iodine excretion (EIU) levels, and Hb levels. Results: The results showed that the subjects’ mean age was 37.0±13.3 months, and most subjects (54.9%) were male. The biochemical examination showed that the mean serum zinc levels, the median urine iodine levels, and the mean Hb levels were 72.5±6.3 g/dL, 78.5 g/L, and 12.7±1.8 g/dL, respectively. 17.6% of the subjects had anemia, 14.3% had zinc deficiency, and 60.4% had iodine deficiency. Conclusion: Children under five aged 12-59 months in Lebih Village had micronutrient deficiencies such as zinc, iodine, and iron

Physical activity interventions for adults who are visually impaired : a systematic review and meta-analysis

Objectives: Compared with sighted individuals, people with visual impairment have a higher prevalence of chronic conditions and lower levels of physical activity. This review aims to systematically review physical activity interventions for those with a visual impairment and to assess their effectiveness. Design: A systematic review of articles reporting physical activity interventions in visually impaired individuals was conducted. Medline, EMBASE, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, SPORTDiscus and the Physiotherapy Evidence Database were searched in August 2018. Meta-analyses were conducted on randomised controlled trials with the same outcome measure. Setting: Most interventions were conducted in a group setting, with some including an at-home, self-directed component. Participants: Following identification of a recent systematic review of physical activity interventions in children, our review focused on adults aged 18 years and older with a visual impairment. Primary and secondary outcome measures: Outcomes included measures of balance, mobility, mental well-being (eg, quality of life), number of falls, muscle strength, flexibility and gait. Results: Eighteen papers from 17 studies met inclusion criteria. Physical activity components include falls prevention and/or balance-based activities, walking, tai chi, Alexander Technique, Yoga, dance, aerobics and core stability training. Significant results in favour of the intervention were reported most commonly in measures of functional capacity (9/17 studies) and in falls/balance-related outcomes (7/13 studies). The studies identified were generally small and diverse in study design, and risk of bias was high across several categories for most studies. Meta-analyses indicated non-significant effects of the included interventions on the Timed Up and Go, Chair Sit Test and Berg Balance Scale. Conclusions: Physical activity interventions in individuals with visual impairment incorporating activities such as tai chi, Yoga and dance can have positive results, particularly in physical measures such as mobility and balance. However, when performing a meta-analysis of randomised controlled trials, the evidence for effectiveness is less clear. More studies with larger sample sizes, stronger designs and longer follow-up periods are needed

Implementation of smoke-free law in Denpasar Bali: Between compliance and social norms of smoking

Background: Since 2013, City of Denpasar government has adopted a smoke-free law. Implementation of the law faces several obstacles, partly due to the high social acceptability of smoking in the city, where cigarette and smoking has been deeply engrained within social life and become part of hospitality. This study aims to assess the smoke-free law compliance and to explore the social norms that may affect the compliance. Design and Methods: The study was a mix of cross-sectional compliance survey and qualitative exploration conducted in Denpasar in 2019. Survey included 538 samples, which were selected using stratified random sampling and a walking protocol. The qualitative data was collected through in-depth interviews and Focus Group Discussion (FGD) in four sub-districts of Denpasar.Results: Of the 538 venues, 32.9% complied with the seven compliance indicators. The university has the highest compliance (83.3%), while public places including worship places have a low compliance. The three most common violations were the absence of no-smoking signage (58.6%), provision of ashtray (17.5%), and smell of tobacco smoke (15.8%). The poor compliance was related to the lack of awareness of the regulation, and the fact that smoking is highly acceptable and part of the culture. The informants highlighted the essential role of public figures and potency of local policy as social disapproval of smoking.Conclusions: Compliance to the smoke-free law in Denpasar remains low, continuous education, socialization and improved supervision are crucial. Meanwhile, social and cultural acceptance of smoking is considered as an essential factor that hampers the implementation of the smoke free law

Marketing to the selfie generation: a case study of " A" cigarette brand marketing communication in Indonesia

Background Incomplete bans of tobacco advertising, promotion and sponsorship [TAPS] in Indonesia enable the tobacco industry to exploit both direct and indirect cigarette promotion. Alongside its annual SoundrenAline concert to promote Sampoerna A cigarette brand, PT HM Sampoerna used social media and its corporate website to develop its brand image. This study aims to describe an integrated marketing communication (IMC) strategy of Sampoerna A brand and how Instagram and the corporate website were leveraged to broaden the marketing campaign reach and to increase engagement with young people. Methods A case study of the A cigarette brand IMC was conducted by gathering data from three main sources. HM Sampoerna reports and company websites were reviewed. Four pairs of observers conducted an observation survey, systematically auditing and documenting tobacco promotion and advertising at the 2016 SoundrenAline concert. Social media data was obtained from a search of hashtags on Instagram. The ten most frequently used hashtags related to the concert were reviewed and documented. Results An IMC strategy of the A brand was conducted through consistent brand image communication across different medium including the live music event and a virtual event on the corporate websites and social media accounts. Instagram boosted event promotion with more than 25,000 posts for the two main hashtags that were endorsed during the concerts. HM Sampoerna evaded the advertising law by changing the concert name, using pictorial health warnings on the promotional material and including an age 18+ restriction to both the concert and to the websites. Conclusions This case study provides evidence that PT HM Sampoerna has exploited loopholes in the incomplete Indonesian tobacco control regulation and has embraced social media and the internet to leverage its cigarette marketing. Indonesian tobacco advertising bans need to be reformed to include internet and social media advertising in order to effectively protect young people

Compliance with Smoke-Free Legislation and Associated Factors: A Serial Survey in Bali, Indonesia

This study aims to describe the compliance to the smoke-free legislation and to identify the associated factors. A cross-sectional study was conducted to assess the compliance at all smoke-free venues. A number of 5,500 smoke-free venues were involved. The data was collected on a six monthly basis through observation and interviews. The study observed 6,670 buildings. The compliance was 11.8% in the second semester of 2013 (1st) as the baseline, which increased to 62.0% in 2015 (5th). Meanwhile, the most common violations of smoke-free legislation were found to be cigarette butts, the provision of ashtrays and smoking. Factors that were associated with compliance were awareness, knowledge and support of the legislation and the presence of internal monitoring. The compliance with Bali’s smoke-free legislation remains suboptimal, despite showing increasing trends over time. Hence, continuous education and supervision should be conducted for venue managers to increase compliance

From the international tobacco control arena to the local context: a qualitative study on the tobacco advertising, promotion and sponsorship legislative environment in Sudan and the challenges characterising it

Objectives The aim of the study was to assess the Sudanese tobacco advertising, promotion and sponsorship (TAPS) legislative environment and the challenges characterising it. We formulated three research questions: What is the TAPS policy context in Sudan? What circumstances led to the development of the current legislative text? Finally, what was the involvement of the different actors in these events?Design We conducted a qualitative analysis using the Health Policy Triangle model to frame the collection and extraction of publicly available information from academic literature search engines, news media databases or websites of national and international organisations, as published by February 2021. The thematic framework approach was employed to code and analyse the textual data and the generated themes were used to map connections across the data and to explore relationships among the generated subthemes and themes.Setting Sudan.Data Using a combination of the keywords “Sudan” and “tobacco advertising” (or “tobacco marketing” or “tobacco promotion”), we collected publicly available documents in the English language. We included 29 documents in the analysis.Results Three themes underpin the Sudanese legislative environment on TAPS: (1) limited and outdated TAPS data, (2) stakeholder involvement and tobacco industry interference and (3) TAPS legislation not aligned with the WHO Framework Convention on Tobacco Control Secretariat recommendations.Conclusions Findings from this qualitative analysis suggest that recommendations to move forward in Sudan should include the systematic and periodic collection of TAPS surveillance data, addressing any remaining legislative content loopholes and protecting policy-making from tobacco industry interference. In addition, best practices from other low-income and middle-income countries with good TAPS monitoring systems, such as Egypt, Bangladesh and Indonesia, or with protective provisions against tobacco industry interference, such as Thailand and the Philippines, could be considered for adaptation and implementation

Achieving a tobacco-free Bangladesh by 2040: a qualitative analysis of the tobacco advertising environment and prohibitions in Bangladesh

Objectives This paper explores the Bangladeshi tobacco advertising, promotion and sponsorship (TAPS) legislative environment, to highlight any potential policy loopholes and to facilitate the identification of additional provisions for inclusion. The study also aimed to identify valuable lessons applicable to other low-income and middle-income countries (LMICs).Methods We conducted a qualitative health policy analysis using the health policy triangle model to frame the collection and extraction of publicly available information from academic literature search engines, news media databases and websites of national and international organisations, published up until December 2020. We coded and analysed textual data using the thematic framework approach to identify themes, relationships and connections.Results Four themes underpin the Bangladesh legislative environment on TAPS: (1) engaging international actor interest in TAPS policies, (2) the incremental approach to TAPS policy-making, (3) time-sensitive TAPS monitoring data and (4) innovative TAPS monitoring and policy enforcement system. The findings highlight the role of international actors (such as multinational organisations and donors), tobacco control advocates and the tobacco industry in the policy-making process and the competing agendas they bring. We also outline the chronology of TAPS policy-making in Bangladesh and the existing loopholes and policy changes over time. Lastly, we describe the innovative approaches to TAPS monitoring and policy enforcement in Bangladesh to combat the tobacco industry marketing strategies.Conclusion This study highlights the role of tobacco control advocates as crucial in TAPS policy-making, monitoring and enforcement in LMICs, and identifies good practices for the sustainability of tobacco control programmes. However, it also points out that tobacco industry interference, coupled with increasing pressure on advocates and legislators, may block progress in tobacco endgame approaches