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Objective Breast self-examination (BSE) is the most feasible screening tool compared with clinical breast examination and mammography. It is crucial to address the associated factors of practising BSE to develop a targeted BSE promotion programme and improve the BSE quality in Thai women, particularly during the COVID-19 pandemic.Design and setting We conducted a cross-sectional study in Thailand’s north and northeast region from March 2020 to November 2022.Participants This study involved 405 women aged 30–70 years old.Variables and outcomes Demographic information, health status and BSE were collected using a modified questionnaire based on the Champion Health Belief Model. The outcomes were ever-practising BSE, BSE practice within the last 6 months, continuity of BSE and confidence in doing BSE. Logistic regression and decision tree analysis identified the associated factors.Results 75.55% of participants ever performed BSE. Around 74.18% did BSE within the last 6 months. Diploma graduates (adjusted OR (aOR) 25.48, 95% CI 2.04 to 318.07), 21–40 reproductive years (aOR 4.29, 95% CI 1.22 to 15.08), ever pregnant (aOR 3.31, 95% CI 1.05 to 10.49), not drinking alcohol (aOR 2.1, 95% CI 1.04 to 4.55), not receiving hormone replacement (aOR 5.51, 95% CI 2.04 to 14.89), higher knowledge (aOR 1.29, 95% CI 1.09 to 1.52), attitude (aOR 1.15, 95% CI 1.05 to 1.26) and practice/cues of action towards BSE were associated with ever-practising BSE. Frequent high-fat diet, high awareness of breast cancer, lower knowledge of BSE and lower attitude toward BSE were associated with not practising BSE within 6 months and BSE discontinuation. Only high knowledge of BSE was associated with absolute confidence in BSE (p

Self-care management is the way to prevent the complication in diabetes. However, adherence to self-care management is low. This study aims to assess the association of personal characteristics, supports the system, including families and community, with the self-care behavior among diabetes patients. A cross-sectional study was used in this research. 158 participants were randomly selected based on the primary health care database in Malang City, Indonesia. There are eight parts of the questionnaire as the instruments in this study. Multivariate logistic regression was used to analyze the association of all independent variables with self-care behavior as a dependent variable. This study showed that 60.80% of respondents had complications while the less practicing self-care behavior was 46.84%. Furthermore, the ordinal regression logistic showed that duration of DM (OR:4.347, 95%CI 1.671-11.310), illness perception (OR: 0.028, 95%CI 6.090- 51.346), family supports (OR: 3.295, 95%CI 1.325-8.192), and community supports (2.802, 95%CI 1.209-6.493) were associated with self-care behavior among diabetes Mellitus. This finding can support the primary health care to involved family and community around diabetes patients to success the self-care management.

High sugary beverages have recently gained popularity among young adults. This research aimed to determine the association between smartphone usage and dietary consumption of Sugar-Sweetened Beverages among young female adults in Indonesia. This cross-sectional study conducted an online survey in Malang City. There were 217 female university students aged 18-25 years old who were eligible as participants. The dependent variable was a preference for SSBs consumption, while the independent variables included sociodemographics, BMI, food allergies, smartphone usage, and dietary habits. Chi-square and binary logistics were used to analyse the association between independent variables and SSBs. The results showed that 62.2% of respondents preferred to consume SSBs, and 12.9% of participants were classified as overnutrition (BMI25). More than half of the respondents had breakfast every day, and a majority of them like to consume high carbohydrates (96.8%) and high-sugar snacks (55.3%). The binary logistic regression showed an association between BMI status, breakfast consumption, watching movies, and eating frequency with high sugar beverage consumption preference (p0.05). Reducing sugar beverages consumption intervention should consider using media accessible with smartphone.

Abstract Exposure to heavy metals in mining activities is a health issue among miners. This study was carried out at three small-scale gold mining sites situated in Banmauk Township, Myanmar and aims to assess the occupational health risks of small-scale gold miners who are exposed to arsenic (As), cadmium (Cd), mercury (Hg) and lead (Pb) in the soil through the dermal route. Soil samples were analyzed through atomic absorption spectroscopy (AAS). The concentrations of the heavy metals in soils found As, ranged 1.04 mg/kg to 22.17 mg/kg, 0.13 mg/kg to 3.07 mg/kg for Cd, 0.15 mg/kg to 77.44 mg/kg for Hg, and 7.67 mg/kg to 210.00 mg/kg for Pb. In this study, 79% of the participants did not use any form of personal protective equipment (PPE) while working in gold mining processes. Regarding noncancer risk assessment, the results found all hazard quotient were lower than acceptable level (HQ

Abstract Human biomarkers were used to evaluate the lead (Pb) and arsenic (As) exposure of local people who lived in an agricultural area with intense agrochemical usage and who consumed groundwater. Although the heavy metals/metalloids in the groundwater were at low concentrations, they could cause adverse effects due to a high daily water intake rate over the long term. Biomarkers (hair, fingernails and urine) were collected from 100 subjects along with the local shallow groundwater and tap water, which is the treated deep groundwater, and investigated for the concentrations of As and Pb. Shallow groundwater had an average pH of 5.21 ± 1.90, ranging from 3.77 to 8.34, with average concentrations of As and Pb of 1.311 µg/L and 6.882 µg/L, respectively. Tap water had an average pH of 5.24 ± 1.63, ranging from 3.86 to 8.89, with the average concentrations of As and Pb of 0.77 µg/L and 0.004 µg/L, respectively. The levels of both As and Pb in the hair, fingernails and urine of shallow groundwater-consuming residents were greater than those in the hair, fingernails and urine of tap water-consuming residents. Interestingly, the As level in urine showed a linear relationship with the As concentration in groundwater (R2 = 0.91). The average water consumption rate was approximately two-fold higher than the standard; thus, its consumption posed a health risk even at the low As and Pb levels in the groundwater. The hazard index (HI) ranged from 0.01 to 16.34 (average of 1.20 ± 2.50), which was higher than the acceptable level. Finally, the concomitant factors for As and Pb in the urine, hair and nails from both binary logistic regression and odds ratio (OR) analysis indicated that groundwater consumption was the major concomitant risk factor. This study suggested that direct consumption of this groundwater should be avoided and that the groundwater should be treated, especially before consumption. In conclusion, urine is suggested to be a biomarker of daily exposure to As and Pb, while for long-term exposure to these metals, fingernails are suggested as a better biomarker than hair.

Background. Artisanal and small-scale mining activities are widely practiced globally. Concentrations of heavy metals associated with gold, such as copper (Cu), zinc (Zn), arsenic (As), cadmium (Cd), mercury (Hg) and lead (Pb) can increase in the environment as a result of mining activities, leading to environmental pollution and pose toxicity risks to humans and animals. Objectives. The aim of the present study was to investigate soil concentrations of toxic heavy metals in placer small-scale gold mining operations in Myanmar. Methods. Soil samples were collected from three placer small-scale gold mining sites: Site A located in the Hmawbon public protected forest, Site B and Site C, situated in the Nant-Kyin reserved forest around Nar Nant Htun village. At each site, soil samples were collected from four gold mining stages (ore processing, sluicing, panning, and amalgamation). Atomic absorption spectroscopy was utilized to examine the concentrations of As, Cd, Pb, and Hg. Results. The highest heavy metal concentrations were generally found in the amalgamation stages across all the gold mining sites. Across the three mining sites, the maximum heavy metal concentrations in the amalgamation stage were 22.170 mg.kg−1 for As, 3.070 mg.kg−1 for Cd, 77.440 mg.kg−1 for Hg, and 210.000 mg.kg−1 for Pb. Conclusions. The present study examined the concentrations of As, Cd, Hg and Pb in the soil of several small-scale gold mining sites in Banmauk Township, Myanmar. The results demonstrated the presence of high concentrations of heavy metals in the soil of the gold mining sites. Miners in this area work without proper personal protective equipment, and frequent exposure to heavy metals in the soil may cause adverse health effects. The present study provides baseline data for future risk assessment studies of heavy metal contamination in gold mines. Competing Interests. The authors declare no competing financial interests

BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic disrupts self-management in diabetic patients in Indonesia. This study aimed to determine the telemedicine usage and factors contributing to glycemic control in type 2 diabetes mellitus (T2DM) patients during the pandemic. METHODS A cross-sectional study was conducted in T2DM patients aged 25-54 years. The questionnaire included general characteristics, diabetes conditions, consultation factors, and self-care management. Glycemic status was evaluated using glycated hemoglobin (HbAic) levels, which was categorized into poor (HbA1c>7%) and good glycemic control (HbAic<7%). Data were analyzed using chi-square and binary logistic regression. RESULTS Of 264 patients, only 19.2% used telemedicine and 60.2% had poor glycemic control during the pandemic. Overweight or obesity (odds ratio [OR] = 5.740 [95% confidence interval [CI] = 2.554-12.899]; p<0.00i), insulin injection (OR = 3.083 [95% CI = 1.238-7.677]; p = 0.016), and frequent fried food consumption (OR = 5.204 [95% CI = 1.631-16.606]; p = 0.005) were the factors contributing to poor glycemic control. The risk is lower if exercised regularly (OR = 0.036 [95% CI = 0.007-0.195]; p<0.00i) and consulted with a doctor using telemedicine (OR = 0.193 [95% CI = 0.044-0.846]; p = 0.029) or in-person visits (OR = 0.065 [95% CI = 0.016-0.260]; p<0.001). CONCLUSIONS Glycemic control was not optimal during the COVID-19 pandemic. Therefore, keeping a healthy lifestyle and staying connected with a doctor are important to ensure optimal blood glucose control and reduce the risk of diabetes-related complications. [ABSTRACT FROM AUTHOR]

The objectives of this research were (1) to investigate the levels of Cd, Cr, Cu, Pb, Mn, and Zn in the breast milk of lactating mothers who working in industrial area (2) to investigate associated factors related with heavy metals in breast milk. 44 breast milk samples were analyzed by ICP-MS, the average Cd was 0.31+1.42 µg/L, Cr was 14.06+46.81 µg/L, Cu was 9.99+4.59 µg/L, Pb was 8.64+18.67 µg/L, Mn was 7.18+25.72 µg/L, Zn was 16.06+10.33 µg/L. Chi square presented that Cr, Pb, Mn was associated with period of work experience, Cr, Mn, Zn was associated with green leafy vegetable consumption (p<0.05). Binary logistic regression presented positively significant association between Pb in breast milk of factory workers and working in factory experience (95%CI was 1.085-38.699), and also showed positive significant relationship between Cu in breast milk and working hours per week of factory workers (95%CI was 1.019-14.758). Thus this study can serve as a representative of heavy metals exposure of lactating mothers and also provide the database of heavy metals in breast milk of industrial factory workers. [ABSTRACT FROM AUTHOR]