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Objective: This case report aims to determine the effectiveness of tandem walking interventions in the elderly with a diagnosis of fall risk in the community. Methods: This case uses a case report involving one elderly person in a community with a high risk of falling category. The tandem walking intervention was carried out for ten days at least once a day, and a Tinetti Gait and Balance test was carried out to see the fall risk category before and after the tandem walking intervention was given. Results: After being given the tandem walking nursing intervention for ten days, although there was no change in the fall risk category, there was a decrease in the Tinetti Gait and Balance score compared to before the intervention. In addition, the elderly said that after doing tandem walking, their walk was more balanced, and they did not need assistance when walking by holding the wall around it like before. Conclusion: The results of this case report only involved one elderly, but the interventions provided can reduce this bias because they can reduce the risk score of falling Thus, case report can be used as an initial study for further research related to modification of tandem roads in the context of the elderly population in a larger sample with a true experiment design.

To describe the prevalence and the correlation between individual, environmental and household, health behavior, and source of information factors with diarrhea among under-five children in five Southeast Asian countries based on the National Health Survey.Cross-sectional design conducted in five countries in Southeast Asia. Datasets from Demographic and Health Surveys and Multiple Indicator Cluster Surveys in five countries were analyzed.A total of 12,447 children under 5 years of age from five countries in Southeast Asia (Indonesia 1807, Cambodia 2650, Myanmar 1717, the Philippines 3669, and Timor-Leste 2614) were included in this study. Binary logistic regression was performed to analyze the data. A total of 12,447 under-five children were included in the study. Overall, in five Southeast Asian countries, the prevalence of diarrhea is known from 8.39% in the Philippines to 18.21% in Indonesia. Several factors related to diarrhea are individual; environmental and household; health behavior such as stool disposal, breastfeeding mothers, and children's food history; and source of information factors.The findings of this study indicate that diarrhea is a serious public health problem in the Southeast Asian region that must be addressed using preventive and curative approaches.The results indicate the need for cross-collaboration among nurses, medical doctor, and sanitarian is needed to tackle the childhood diarrhea and minimize the severity based on those determinants.

Kusman Ibrahim,1 Laili Rahayuwati,2 Yusshy Kurnia Herliani,1 Iqbal Pramukti2 1Department of Medical and Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, Indonesia; 2Community Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, IndonesiaCorrespondence: Kusman Ibrahim, Department of Medical and Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Jl. Raya Bandung-Sumedang KM. 21, Jatinangor, Sumedang, West Java, 45363, Indonesia, Tel +62-81321281117, Fax +62 22-7795596, Email k.ibrahim@unpad.ac.idBackground: Human immunodeficiency virus remains a major public health problem in Indonesia. People living with HIV (PLWH) have various health problems as result from disease progression that impacts their health care needs. This study aims to explore health care needs and to test the factors associated with health care needs among people living with HIV.Methods: A cross-sectional descriptive study design was undertaken with 243 respondents completing a self-reported HIV-Health Care Need Questionnaire. Participants were recruited using the purposive sampling technique from six HIV clinics in West Java, Indonesia. The data were analyzed using descriptive and multiple logistic regression statistical techniques.Results: The majority of the subjects were diagnosed within less than 5 years and have been receiving antiretroviral therapy. Nursing care was indicated as the most needed, offered, and received care. Emergency financial assistance, legal services, insurance premiums, and nutritional intervention were perceived as gaps between needed and received. Characteristics such as age, educational background, having HIV manager, and income were significantly correlated to nutritional care (p< 0.05). Nutritional care was increased by 3.96% if PLWH having HIV manager (CI: 1.17– 13.38, p< 0.05).Conclusion: Addressing the gap between health care needs and health offered was important to ensure that care was received appropriately. Continuing assessment of health care needs can provide direction to deliver appropriate care and ensure a comprehensive continuum of care for PLWH.Keywords: continuum of care, continuity of patient care, health services, HIV testing, needs

Diabetic retinopathy (DR) adalah salah satu komplikasi kronis dari diabetes mellitus terhadap mata. Apabila tidak ditangani dengan baik, maka DR dapat menyebabkan kebutaan. Peran perawat yaitu meningkatkan pengetahuan dan kemampuan guna melakukan pengontrolan terhadap penyakitnya. Penelitian ini bertujuan untuk menganalisa hubungan antara peran perawat sebagai educator dengan pengetahuan dan kesadaran pada pasien diabetic retinopathy di Pusat Mata Nasional Rumah Sakit Mata Cicendo. Jenis penelitian ini adalah analitik dengan pendekatan cross sectional. Pengambilan data dilakukan di instalasi rawat jalan rumah sakit rujukan tersier. Sumber data berupa data primer melalui kuesioner peran perawat sebagai edukator dan kuesioner Knowledge and Awareness of Patients With Diabetic Retinopathy dan data sekunder berupa data pasien diabetic retinopathy tahun 2020. Responden terdiri dari 97 pasien DR. Penelitian dilakukan bulan April sampai dengan Juni 2021 di Pusat Mata Nasional Rumah Sakit Mata Cicendo. Analisis data dilakukan dengan menggunakan uji Chi-Square dengan tingkat signifikansi 0,05. Hasil penelitian menunjukkan terdapat hubungan yang signifikan antara peran perawat sebagai edukator dengan pengetahuan dan kesadaran pada pasien DR (p = 0,003). Semakin tinggi nilai peran perawat sebagai edukator maka semakin tinggi pengetahuan dan kesadaran pada pasien DR. Penelitian ini mengungkapkan bahwa perawat harus dapat mengoptimalkan pendidikan kesehatan untuk pasien DR sehingga pasien dapat meningkatkan kualitas hidupnya.

Health promotion in schools is a strategic step in improving public health. This is because health promotion through the school community is quite effective in increasing public awareness in carrying out clean and healthy living behaviors. School age is very good for providing education and understanding about Clean and Healthy Life Behavior (PHBS), one of which is education about nutrition. Optimal nutrition intake, both in terms of quantity and quality, is very important for optimal growth and development. For this reason, our diet needs to be improved towards the consumption of balanced nutrition. Balanced nutrition is a balanced diet of daily food that contains nutrients in the type and amount according to the body's needs. The purpose of the activity is to create students, teachers and the school environment community to implement PHBS, create a healthy, clean and comfortable school environment, be able to improve education in schools, create health services in schools that can be put to good use, especially nutrition action. The method used is the lecture method via whatsapp, poster installation, question and answer and group discussion. The results of the health education activities were approximately 67 participants. The counseling participants looked enthusiastic when the material was given. Participants participated in the counseling happily because the counseling was carried out in a fun way. The counseling activity was conducive because the participants paid attention to the material presented well. This is evidenced by the number of participants who are interested in answering questions during the question and answer session. Participants participated in the counseling happily because the counseling was carried out using a fun online method. Counseling activities are conducive because the community pays attention to the material presented well

Self-efficacy is a person’s belief or confidence in doing something. Self-perception related to confidence in the learning process or learning strategy is often called “learning self-efficacy” where it reflects how confident a learner is in achieving certain learning objectives in the context of performing clinical skills of urinary catheterization. In developed countries, virtual reality is proven to be able to increase student self-efficacy but in developing countries there is still limited research. The purpose of this study was to see the effect of virtual reality learning media on the self-efficacy of nursing students in the learning process in Indonesia as a developing country. This research design is a quantitative study with a pre-experiment research design with one intervention group with a pre-test post-test design approach. The sampling technique used was purposive sampling with 49 nursing students of the Faculty of Nursing, Padjadjaran University as samples. The instrument used in this study was the Learning Self Efficacy Scale (L-SES) for Clinical Skills questionnaire consisting of 12 question items. Data analysis was carried out univariately and bivariately using the dependent t-test because the data were normally distributed. The results showed that there was a significant difference between the pre-test and post-test which showed an average increase of 13.65 points. The use of VR learning media in the act of urinary catheterization and static results show a value of p = 0.001

Human factors are very complex in the spread of disease. Stunting is caused by chronic malnutrition and infections in toddlers. Lack of access to clean water, hygiene, and sanitation contributes to stunting. Demographic factors can affect a person’s motivation to maintain hygiene. This study aims to be determined the correlation between demographic characteristics and water, sanitation, and hygiene (WASH) practices at the stunting locus. The method in this study used a correlational quantitative method with a cross-sectional design to be measured demographic characteristic and WASH practices variables. The study population consisted of Sukamulya village residents, and 463 Sukamulya village residents were sampled using total sampling. SPSS Version 26 for Windows was used for univariate and bivariate Chi-Square analysis. The results showed that 228 (49.2%) out of 463 of respondents had poor WASH practices. The results of the correlation test showed that there was a correlation between level of education and WASH practices with a score of Chi-Square 17,564 (p-value = 0,002). There is a correlation between education level and WASH practices at the stunting locus. Education affects a person’s perspective and decision-making, including environmental hygiene and health. Thus, the government and policymakers should hold WASH programs to educate the public about keeping the stunting locus clean.

Keselamatan dan kesehatan kerja (K3) merupakan sistem yang melindungi pekerja, perusahaan, lingkungan hidup, dan masyarakat sekitar dari bahaya akibat kecelakaan kerja. Keselamatan dan kesehatan pemilik serta pegawai saling berhubungan erat dengan keefektifan kerja, sehingga sangat penting sekali untuk dijaga dan dipelihara. Penerapan keselamatan dan kesehatan kerja sangat penting khususnya pada perusahaan yang berkaitan secara langsung dengan bidang produksi. Aksesoris Sangkar Burung Kiara G.357 merupakan salah satu usaha home industri, dimana usaha tersebut beroprasi sejak tahun 1990 an hingga saat ini. Kondisi pandemi Covid-19 ini juga tidak memudarkan semangat pemilik beserta karyawan pengelolanya untuk terus produktif menjalankan usaha tersebutn. Tujuan kegiatan adalah memberikan edukasi untuk Menjelaskan tentang kesehatan dan keselamatan kerja khususnya penggunaan APD dalam upaya mencegah resiko kerja di home industri. Metode yang digunakan dalam kegiatan ini adalah melalui pemutaran video, ceramah, dan diskusi serta tanya jawab. Hasil yang dicapai setelah dilakukan pendidikan kesehatan melalui penyuluhan, para peserta menyatakan dapat mengetahui dan memahami serta mengungkapkan kembali tentang kesehatan dan keselamatan kerja khususnya penggunaan APD dalam upaya mencegah resiko kerja di home industri. Kata Kunci: APD, Home Industri, Kesehatan Keselamatan Kerja ABSTRACT Occupational safety and health (K3) is a system that protects workers, companies, the environment, and the surrounding community from the dangers of work accidents. The safety and health of owners and employees are closely related to work effectiveness, so it is very important to protect and maintain them. The application of occupational safety and health is very important, especially in companies that are directly related to the production sector. Kiara G.357 Bird Cage Accessories is one of the home industry businesses, where the business has been operating since the 1990s until now. The condition of the Covid-19 pandemic has also not dampened the enthusiasm of the owners and their managing employees to continue to be productive in running the business. The purpose of the activity is to provide education to explain occupational health and safety, especially the use of PPE in an effort to prevent work risks in the home industry. The method used in this activity is through video screenings, lectures, and discussions as well as questions and answers. The results achieved after health education was carried out through counseling, the participants stated that they could know and understand and reveal again about occupational health and safety, especially the use of PPE in an effort to prevent work risks in the home industry. Keywords: PPE, Home Industry, Occupational Health

BACKGROUND: Child sexual abuse (CSA) is a serious global problem and challenge for all people because it increases the risk of various issues. AIM: This study investigated the CSA in Asian countries focusing on prevalence rates, impact, victim’s age of first exposure, type of CSA, perpetrator, and places of CSA offence. METHODS: We searched PubMed, Medline, ProQuest, ScienceDirect, CINAHL, Academic Search Complete, ClinicalKey, PsycINFO, Google Scholar, and manual search for studies published between January 2011 and November 2020. Only articles related to CSA in Asia were included in this review. RESULTS: The results showed that prevalence of CSA ranged from 2.2% - 94% for girls and 1.7% - 49.5% for boys. The prevalence rates for non-contact abuse were 12.6% - 56.5% for girls and 0.7% - 68.7% for boys; contact abuse was 5.3% - 67.2% for girls and 2.2% - 53.3% for boys; penetrating abuse was 0.5% - 88.24% for girls and 1.7% - 57.1% for boys. The findings reported most victims’ age of first exposure was preteen. The rate of the violation occurring in the victim’s house was 6.1% - 41.9%; most CSA perpetrators are known by victims. This study reported adverse impacts on CSA victims such as psychological, health, and physical disorders, and changes in behavior. In addition, other findings were found, including recovery, perceptions, values, causes, and expectations of victims of CSA. CONCLUSIONS: The incidence of CSA in Asia is still high and the age of the first victims is early adolescence. The majority of victims are women who already know the perpetrator, and taboo cultural factors are thought to play a role in increasing CSA in Asia. The results indicate the need to develop CSA prevention efforts that involve culture.

Introduction The COVID-19 pandemic has been affecting many aspects including education globally as many countries closed the school temporally. This study aimed to summarize the effectiveness of the-education application among health-fields university students Methods PubMed and EBSCO databases for studies published up to August 2020 were searched. Studies reporting the academic performance or skills performance or students satisfaction were included. Study quality was assessed using the Joanna Briggs Institute (JBI) appraisal tool. Result Published between 2002 and 2020, 22 studies were conducted in developed countries, and 2 studies in developing countries. The tele-education method included e-learning, virtual, and digital learning. When comparing to the control group, of fifteen studies intervention studies measuring academic performance, seven studies showed a higher mean score among the intervention group. For skills performance, there were no studies showing higher skill performance. For studies measuring student satisfaction, one-third showing higher students’ satisfaction among the intervention group compared to the control. Conclusion Our finding highlighted the positive effect of various tele-education on academic performance among the health-field university students. Applying the various tele-education in the learning process for health-field university students during the COVID-19 Pandemic is suggested. Keywords: health field students, tele-education, pandemic, effectiveness

BACKGROUND: Helplessness is a factor that adversely affects patients with coronary heart disease (CHD). The factors related to this situation have become essential to be investigated. Meanwhile, one of the factors that have the potential to reduce this situation is social support. However, there has been no research related to this in the Indonesian population. AIM: Therefore, this study aims to assess the relationship between social support and helplessness among patients with CHD. METHODS: This was a correlational study where 107 outpatient and inpatient patients at a hospital in West Java, Indonesia, were obtained. The data were collected using a demographic questionnaire, Illness Cognition Questionnaire on the dimensions of helplessness, and the Enhancing Recovery in CHD Social Support Inventory. Furthermore, the data were analyzed by Pearson and linear regression. RESULTS: The respondents were 78% of males, while 22% were female. Most of the patients (88%) were married. The bivariate analysis showed that social support and its subvariable emotional support were significantly related to helplessness (p < 0.05, r = −0.248), while the other subvariable structural and instrumental support were not significantly related (p > 0.05). The regression analysis results showed that social and emotional support had a significant effect (p < 0.05) with R2 (95% CI) of 042 and 0.05, respectively. CONCLUSIONS: The social and emotional support among CHD patients was associated with helplessness. The higher the supports obtained, the lower the patient’s helplessness. Therefore, nurses need to encourage family or those closest to patients to provide adequate social and emotional support.

Pramukti I, Strong C, Chen IH, et al. Psychol Res Behav Manag. 2022;15:1617-1625. The authors have advised that there was an error in the Research Ethics section on page 1623. Line 2, the text “(IRB ref: B-ER11-220)” should read “(IRB ref: B-ER-110-220)”. The authors apologize for this error.

BACKGROUND: Internet has been of great benefit to human life, however, it has some disadvantages which exist particularly among young people. AIM: Therefore, this study aims to investigate the internet usage and risky sexual behavior among high school students in a suburban area in Indonesia. METHODS: This was a cross-sectional study carried out using stratified random sampling in a high school located in a suburban area in West Java, Indonesia. Furthermore, self-administered Modified Internet Sex Screening Test (ISST) questionnaire was applied to measure the risky sexual behavior among the students. RESULTS: The results showed that based on the overall risky sexual behavior from internet usage, 35 (12.9%), 211 (77.6%), and 26 (9.6%) subjects were at low, medium, and high risk, respectively. Furthermore, the male gender and browsing for sexual content video were discovered to be the significant risk factors associated with risky sexual behavior with an adjusted odds ratio (AOR) of 5.79 (95% CI: 1.15-29.14) and 3.11 (95% CI: 1.03-9.39), respectively. CONCLUSIONS: From the results obtained, it was concluded that the prevalence of risky sexual behavior based on internet usage is high among students. Furthermore, it was discovered that male students need more attention by being involved in healthy sexual education. In addition, the role of policy-maker in filtering the accessible content for students is required.

The present study evaluated the psychometric properties of four instruments related to internet use, namely the Bergen Social Media Addiction Scale (BSMAS), Smartphone Application-Based Addiction Scale (SABAS), (nine-item) Internet Gaming Disorder Scale Short Form (IGDS9-SF), and Nomophobia Questionnaire (NMPQ) as well as their associations with psychological distress among Malaysian university students. A total of 380 Malaysian university students (71.6% females, mean age 24.0 years) were recruited through convenience sampling and completed an online survey including questions concerning socio-demographic background, social media addiction, smartphone addiction, internet gaming disorder, and nomophobia. Confirmatory factor analysis and Rasch analysis were applied to evaluate the psychometric properties of the instruments and Cronbach’s alpha value and McDonald’s omega value were used to confirm the internal consistency reliability of the instruments. The unidimensional structure was confirmed for the BSMAS, SABAS, and IGDS9-SF while the four-factor structure was confirmed for NMPQ. All instruments showed good internal consistency reliability. Promising validity and reliability were confirmed for BSMAS, SABAS, IGDS9-SF, and NMPQ. Therefore, they are useful to assess different types of problematic internet use among university students in Malaysia. Furthermore, a significant association was observed between internet use and psychological distress. The present study is the first to investigate the validity and reliability of BSMAS, SABAS, IGDS9-SF, and NMPQ among Malaysian university students using rigorous psychometric testing methods (i.e., Rasch analysis).

The impact of cyberbullying includes mental health problems and an increased risk of suicide. Psychiatric nurses play an important role in reducing the impact of cyberbullying on students. Nurses, educators, and counselors also play a role to prevent cyberbullying by improving awareness. The purpose of this study is to explore the awareness and involvement of mental nurses and their motivation and confidence in preventing cyberbullying. The research method used in this study was a quasi-experimental pre-post tests study. The sample in this study included 192 respondents. Data analysis used a t-test (pair t-test). This study shows that seminars about cyberbullying and Triple-P e-Parenting are effective in increasing nurses’ awareness regarding the incidence of cyberbullying in adolescents (p < 0.001). The aspects that influence the increase in awareness of mental nurses are attitude (p < 0.001) and parenting (p < 0.001). Awareness of nurses as parents related to cyberbullying is important to prevent cyberbullying in adolescents. Seminars about cyberbullying, the role of parents, and how to prevent cyberbullying are effective in preventing cyberbullying in adolescents by paying attention to the experiences of parents who have children affected by cyberbullying.

Daniel Kwasi Ahorsu,1,&ast; Iqbal Pramukti,2,&ast; Carol Strong,3 Hsiao-Wen Wang,4 Mark D Griffiths,5 Chung-Ying Lin,3,6– 8 Nai-Ying Ko9 1Department of Rehabilitation Sciences, Faculty of Health & Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong; 2Faculty of Nursing, Universitas Padjadjaran, West Java, Indonesia; 3Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 4Department of Hydraulic and Ocean Engineering, National Cheng Kung University, Tainan, 701, Taiwan; 5International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK; 6Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 7Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 8Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 9Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan&ast;These authors contributed equally to this workCorrespondence: Chung-Ying LinInstitute of Allied Health Sciences and Departments of Occupational Therapy and Public Health, Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 1 University Road, Tainan, 701, TaiwanTel +886-6-2353535-5106Fax +886-6-2367981Email cylin36933@gmail.comCorrespondence: Nai-Ying KoDepartment of Nursing, College of Medicine, National Cheng Kung University, 1 University Road, Tainan, 701, TaiwanTel +886-6-2353535-5838Fax +886-6-2377550Email nyko@mail.ncku.edu.twPurpose: The present study examined the differences between international and local university students in Taiwan regarding COVID-19-related variables, anxiety, and suicidal ideation.Participants and Methods: An online cross-sectional survey (sent via an online link in an email) was carried out comprising university students (n=529). The students were assessed on measures (including validated psychometric instruments) of perceived susceptibility to COVID-19, perceived sufficiency of resources, sources of COVID-19 information, perceived satisfaction with support, anxiety and suicidal ideation.Results: Local students had higher susceptibility to COVID-19 (p< 0.001) but decreased sufficiency with resources (p< 0.001) and anxiety (p< 0.001) compared with international students. Staying with family members, satisfaction with support, and information seeking were the factors that predicted anxiety among international students (all p-values< 0.05), while information seeking predicted local students’ anxiety (p< 0.001). Furthermore, staying with family members, susceptibility to COVID-19, and sufficiency with resources were the factors that predicted suicidal ideation among international students (all p-values< 0.05), while being a male and satisfaction with support predicted suicidal ideation among local students (all p-values< 0.05).Conclusion: International students displayed different COVID-19-related challenges compared with local students. More specifically, international students as compared with local students had lower susceptibility to COVID-19 and higher anxiety. Therefore, healthcare providers should pay more attention to international students’ psychological health and awareness regarding impacts of COVID-19 on health.Keywords: anxiety, COVID-19, university students, suicidal ideation, Taiwan

The problem of adolescent reproductive health (ARH) in Indonesia is worrying, especially regarding the Triad Adolescent Reproductive Health (Triad ARH) behavior. Many factors influence ARH behavior. This cross-sectional study explores the association factors between demographic factors, knowledge, and attitudes toward ARH behavior. Six hundred and sixty-eight junior high school and senior high school students were randomly selected from five public schools in Bandung Regency, West Java, Indonesia. The questionnaire used in this study consisted of four parts, namely: (1) demographic data of respondents; (2) knowledge including 20 questions used multiple choice questions; (3) attitude with 12 questions measured using the Likert scale; and (4) behaviors with seven questions measured using Likert scale. Results showed that gender (p = 0.006), age (p = 0.031), and level of education (p = 0.006) were associated with behavior toward ARH behavior, but knowledge (p = 0.582), religion (p = 0.628), ethnic (p = 0.276), and attitude (p = 0.094) were not associated with ARH behavior. Multivariate analysis showed that only gender (p < 0.010) significantly contributed to ARH behavior. Multivariate analysis showed that gender (OR: 2.168, 95% (CI: 1.204–3.904)) significantly contributed to ARH behavior. Based on the results, it can be concluded that the gender factor influences adolescent reproductive health behavior. This study provides further evidence that to promote positive ARH behavior’s among youth in West Java, Indonesia, gender should be put in place and be sustainable, using the media and the Internet and involving the collaboration of parents, teachers, and peers to improve adolescent reproductive health.

A meta-analysis to investigate the difference in fracture risk between individuals with and without HIV infection was performed. People living with HIV had lower bone mineral density (BMD) and greater risks of overall fractures and fragility fractures. Reducing fragility and maintaining skeletal strength for PLWH are urgently needed for this population. The introduction of effective antiretroviral therapy increased the life expectancy of people living with HIV (PLWH). This population now faces problems related to aging such as decreased bone mineral density (BMD) and increased fracture risk. Some antiretroviral therapies may also negatively impact bone health. We performed a meta-analysis to investigate the difference in the fracture risk between individuals with and without HIV infection. We compared BMD, risk of fragility fracture, and risk of all fracture between the two groups. This study included 35 articles with 106,994 PLWH and 228,794,335 controls. PLWH had lower lumbar spine and hip BMD than controls. PLWH had a higher prevalence of all fracture events (4.08% versus 0.44%) and fragility fractures (2.66% versus 2.19%). The relative risks of all and fragility fractures of PLWH were 1.91 (95% confidence interval (CI), 1.46–2.49; p < 0.001) and 1.68 (95% CI: 1.40–2.01; p < 0.001). PLWH also had more vertebral fractures (1.26% versus 0.37%; RR, 1.97; 95% CI: 1.22–3.2; p < 0.05), hip fractures (1.38% versus 0.81%; RR, 1.88; 95% CI: 0.99–3.57; p = 0.05), and wrist fractures (1.38% versus 1.29%; RR, 1.67; 95% CI: 1.13–2.45; p < 0.05) than healthy controls. The pooled incidence of fractures was 1.72 per 100 person-years in PLWH and 1.29 in healthy controls. PLWH had lower BMD and greater risks of all fractures and fragility fractures. Reducing fragility and maintaining skeletal strength for PLWH are urgently needed for this population.

The use of technology-based learning methods in nursing education is necessary in the era of digitalization, but these methods are limited, especially in developing countries, including Indonesia. We aimed to evaluate the effectiveness of the Virtual Nursing Skills Simulation Lab (VNursLab), a web-based nursing skills simulation using 3D technology, to improve the knowledge of nursing skills for intravenous catheterization, satisfaction, and self-confidence of nursing students in Indonesia. A quasi-experimental design was used. A total of 139 nursing students participated and were divided into intervention and control groups (69 and 70 participants, respectively). The intervention group had access to the VNursLab 3D simulator for three weeks and had three meetings. The control group had traditional learning (lecture and three meetings). The data were analyzed using the paired t-test, Wilcoxon test, and Mann–Whitney U test. The means and standard deviations of the post-test values in the two groups for the three parameters were 12.26 + 4.11 vs. 9.67 + 3.13 for nursing skill knowledge, 23.00 + 2.32 vs. 21.70 + 2.68 for satisfaction, and 36.25 + 3.48 vs. 34.96 + 3.39 for self-confidence. We found significant differences between the intervention and control groups regarding knowledge of nursing skills (p < 0.001), satisfaction (p < 0.001), and self-confidence (p = 0.014). The VNursLab 3D simulator could be an alternative learning medium to improve nursing students’ understanding of nursing skills, satisfaction, and self-confidence. However, this medium cannot replace direct practical experience. A combination of the two learning methods, virtual-based learning and hands-on practical learning, is beneficial in helping nursing students achieve nursing competencies.

Background The COVID-19 pandemic has negatively affected the mental health of university students. Objective This study examined the psychological responses toward COVID-19 among university students from 3 countries—Indonesia, Taiwan, and Thailand. Methods We used a web-based, cross-sectional survey to recruit 1985 university students from 5 public universities (2 in Indonesia, 1 in Thailand, and 1 in Taiwan) via popular social media platforms such as Facebook, LINE, WhatsApp, and broadcast. All students (n=938 in Indonesia, n=734 in Thailand, and n=313 in Taiwan) answered questions concerning their anxiety, suicidal thoughts (or sadness), confidence in pandemic control, risk perception of susceptibility to infection, perceived support, resources for fighting infection, and sources of information in the context of the COVID-19 pandemic. Results Among the 3 student groups, Thai students had the highest levels of anxiety but the lowest levels of confidence in pandemic control and available resources for fighting COVID-19. Factors associated with higher anxiety differed across countries. Less perceived satisfactory support was associated with more suicidal thoughts among Indonesian students. On the other hand, Taiwanese students were more negatively affected by information gathered from the internet and from medical staff than were Indonesian or Thai students. Conclusions Our findings suggest that health care providers in Thailand may need to pay special attention to Thai university students given that high levels of anxiety were observed in this study population. In addition, health care providers should establish a good support system for university students, as the results of this study indicate a negative association between support and suicidal thoughts.

A meta-analysis to investigate the difference in fracture risk between individuals with and without HIV infection was performed. People living with HIV had lower bone mineral density (BMD) and greater risks of overall fractures and fragility fractures. Reducing fragility and maintaining skeletal strength for PLWH are urgently needed for this population.The introduction of effective antiretroviral therapy increased the life expectancy of people living with HIV (PLWH). This population now faces problems related to aging such as decreased bone mineral density (BMD) and increased fracture risk. Some antiretroviral therapies may also negatively impact bone health. We performed a meta-analysis to investigate the difference in the fracture risk between individuals with and without HIV infection.We compared BMD, risk of fragility fracture, and risk of all fracture between the two groups. This study included 35 articles with 106,994 PLWH and 228,794,335 controls.PLWH had lower lumbar spine and hip BMD than controls. PLWH had a higher prevalence of all fracture events (4.08% versus 0.44%) and fragility fractures (2.66% versus 2.19%). The relative risks of all and fragility fractures of PLWH were 1.91 (95% confidence interval (CI), 1.46-2.49; p0.001) and 1.68 (95% CI: 1.40-2.01; p0.001). PLWH also had more vertebral fractures (1.26% versus 0.37%; RR, 1.97; 95% CI: 1.22-3.2; p0.05), hip fractures (1.38% versus 0.81%; RR, 1.88; 95% CI: 0.99-3.57; p = 0.05), and wrist fractures (1.38% versus 1.29%; RR, 1.67; 95% CI: 1.13-2.45; p0.05) than healthy controls. The pooled incidence of fractures was 1.72 per 100 person-years in PLWH and 1.29 in healthy controls.PLWH had lower BMD and greater risks of all fractures and fragility fractures. Reducing fragility and maintaining skeletal strength for PLWH are urgently needed for this population.

BACKGROUND After the World Health Organization declared the pandemic for the novel coronavirus disease (COVID-19) on March 11, 2020, psychological response toward COVID-19 is an important issue that should be thoroughly studied. Indonesia has the highest COVID-19 infection cases in South-East Asia countries and Indonesia university students had no prior experience of pandemic. OBJECTIVE This study aimed to identify the anxiety and related factors among Indonesia university students during COVID-19 pandemic. METHODS A cross-sectional study was conducted in two public Indonesia universities (N=937). Participants aged > 20 years old were recruited through online advertisement and social media. The anxiety level was measured using the State-Trait Anxiety Inventory (STAI) tool. A score > 2.5 was defined as high level of anxiety and < 2.5 as low-medium. A logistic regression was used to determine factors associated with anxiety. RESULTS The students (median age=21; IQR 20.0-23.0) were primarily females (n=802, 85.8%). More than one third of the participants (n=362, 38.5%) had high level of anxiety. Six significant factors were found to explain anxiety: post-graduates’ education (adjusted odds ratio [AOR]=1.52; 95% CI=1.01, 2.27), living with family (AOR=1.57; 95% CI=1.09, 2.26), perceived absolute susceptibility (AOR=1.96; 95% CI=1.48, 2.61), satisfaction with friend’s support (AOR=99; 95% CI=1.21, 3.27), satisfaction with faculties’ support (AOR=1.47; 95% CI=1.01, 2.14), and seeking information from news media (AOR=1.53; 95% CI=1.14, 2.07). CONCLUSIONS As more than one-third of university students having high anxiety, healthcare providers should consider launching mental health intervention to address his issue.

BACKGROUND The COVID-19 pandemic has negatively affected the mental health of university students. OBJECTIVE This study examined the psychological responses toward COVID-19 among university students from 3 countries—Indonesia, Taiwan, and Thailand. METHODS We used a web-based, cross-sectional survey to recruit 1985 university students from 5 public universities (2 in Indonesia, 1 in Thailand, and 1 in Taiwan) via popular social media platforms such as Facebook, LINE, WhatsApp, and broadcast. All students (n=938 in Indonesia, n=734 in Thailand, and n=313 in Taiwan) answered questions concerning their anxiety, suicidal thoughts (or sadness), confidence in pandemic control, risk perception of susceptibility to infection, perceived support, resources for fighting infection, and sources of information in the context of the COVID-19 pandemic. RESULTS Among the 3 student groups, Thai students had the highest levels of anxiety but the lowest levels of confidence in pandemic control and available resources for fighting COVID-19. Factors associated with higher anxiety differed across countries. Less perceived satisfactory support was associated with more suicidal thoughts among Indonesian students. On the other hand, Taiwanese students were more negatively affected by information gathered from the internet and from medical staff than were Indonesian or Thai students. CONCLUSIONS Our findings suggest that health care providers in Thailand may need to pay special attention to Thai university students given that high levels of anxiety were observed in this study population. In addition, health care providers should establish a good support system for university students, as the results of this study indicate a negative association between support and suicidal thoughts.

Introduction The purpose of this study was to predict the 10-year risk of fracture among people living with HIV (PLWH) using FRAX™, and to determine the risk factors related to a high probability of fractures. Methodology This study consisted of 288 subjects aged 40 years and above. The ten-year probability of major osteoporotic fractures (MOF) and hip fractures was assessed using the FRAX™ algorithm with bone mineral density (BMD) data. A logistic regression was used to determine risk factors related to a high probability of major osteoporotic fracture and hip fracture. Results The median 10-year probability of fracture was 3.7% (IQR 2.2–6.2) for MOF and 0.8% (IQR 0.3–2.5) for hip fractures. In addition to old age, previous fracture history, and low T-scores, HCV co-infection was associated with a higher risk of hip fractures in PLWH (AOR: 4.3, 95% CI: 1.29–14.33). Old age and low T-scores were also associated with a high probability of MOF. Conclusions HCV co-infection among PLWH is associated with a higher risk of hip fracture. Sustained efforts in terms of pharmacologic and non-pharmacologic interventions in PLWH are necessary to prevent osteoporotic fractures, especially in those with HCV co-infections.

Exclusive breastfeeding is something which has a lot of benefit both for mother and baby. It is recommended by WHO at let for the first six months. Then it also recommended until two years and beyond. In fact, mostly mother only gave their breastmilk to their babies until two months. The method of this study using systematic review-metasynthesize which an extensive of the literature was undertaken. Database searched were: MEDLINE, CINAHL, BioMed Central, Wiley, and EMBASE. Result shown that mother’s view on exclusive breast is an important part in an attempt to promote breastfeeding desire. Even though their view is influenced by her family and surroundings, but finally the decision is on her. This concurs with finding of some researcher who found women who have the experience of breastfeeding, especially within the family, are more likely to choose to breastfeed heir child. Key words:Exclusive breastfeeding, family, mother Abstrak Pemberian ASI eksklusif adalah sesuatu yang memiliki manfaat sangat besar baik bagi ihu maupun bayi. Hal ini sangat direkomendasikan oleh WHO minimal sampai enam bulan pertama kelahiran bayi. Kemudian dapat dilanjutkan sampai usia dua tahun. Pada kenyataannya, kebanyakan ibu memberikan ASI mereka kepada bayinya hanya sampai usia bayi dua bulan. Metode yang digunakan adalah systematic review- metasintesisyang mana menggunakan pencarian literatur secara luas. Database yang dipilih adalah: MEDLINE, CINAHL, BioMed Central, Wiley, dan EMBASE. Hasil penelitian menunjukkan bahwa pandangan ibu mengenai pemberian ASI eksklusif memiliki peranan yang penting dalam usaha meningkatkan keinginan untuk menyusui. Walaupun pandangan mereka dipengaruhi oleh keluarga dan sekitarnya, namun keputusan akhir tetap berada di tangan mereka. Hal ini sejalan dengan beberapa penelitian yang sudah dilakukan oleh beberapa peneliti sebelumnya yang menyebutkan bahwa wanita yang memiliki pengalaman dalam menyusui, khususnya di dalam keluarga akan cenderung memutuskan untuk menyusui bayinya. Kata kunci:ASI eksklusif, keluarga, ibu