Efforts to familiarize clean and healthy life is significant to improve the degree of public health. The strategies for familiarize clean and healthy living behaviors are counseling and checking of clean and healthy life behavior. The purpose of these activities was to increase knowledge, awareness, and potential of clean and healthy life behavior in Kemantren Village, Malang. This dedication involved the participation of the people of Kemantren Village so that the community could realize that health improvement can be started from healthy daily living habits. The method used was counseling, and health checking. The results of the service showed that the community gave a positive response and was very enthusiastic in participating in health education and counseling activities.

Background: Accelerated immunosenescence has been observed in several autoimmune diseases, including systemic lupus erythematosus (SLE). T cell senescence plays an essential role in the destruction of organs in SLE patients. This study aimed to identify the ability of immunosenescence markers to predict SLE disease activity. Methods: Overall, 61 SLE patients and 60 healthy subjects were enrolled in this cross-sectional study. The Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score assessed disease activity. Senescence surface markers of CD4 and CD8 T lymphocytes were measured by flow cytometry (CD4/CD8 ratio, CD28null, CD57, CD45 isoforms [CD45RA and CD45RO], and KLRG1). Enzyme-linked immunosorbent assay (ELISA) was used to measure the serum cytokines (IFNγ and IL-2) and cytomegalovirus (CMV) serology. Complement and anti-dsDNA levels were also evaluated as the comparator for predicting active disease in SLE. Logistic regression models were used to identify the independent predictive factors for active SLE status. Performance of the senescence markers in predicting active disease in SLE was analyzed by receiver operating characteristic (ROC) curve as the area under curve (AUC). Results: SLE patients with active disease had significantly higher CD8+CD28null, CD8+CD57+, CD8+CD45RA+, CD8+CD45RO+, and CD8+KLRG1+ percentages with lower CD4/CD8 ratio than healthy subjects and SLE patients with inactive disease. The highest AUC and sensitivity were seen in CD8+CD28null (AUC 0.801 [0.662-0.940], sensitivity 91.9%, cut off >6.85%) with comparable results to serum complement and anti-dsDNA in predicting active disease. Multivariate analysis showed that CD4/CD8 ratio, CD8+CD28null, and C3 had significantly increased OR for active SLE. Combination models of CD4/CD8 ratio, CD8+CD28null, and C3 yielded the best results for predicting the active SLE (AUC 0.923 [0.848-0.997], sensitivity 81.2%, specificity 84.0%, LR+ 5.08 and LR- 0.22). Conclusions: Our findings demonstrated that combining immunosenescence markers, including CD4/CD8 ratio and CD8+CD28null with C3 levels could increase the odds of predicting active disease in SLE.

Hypertension affects approximately 26% of the adult population and it is a leading cause of death in up to 13.5% worldwide. Hypertension is a disease with the highest prevalence in Indonesia, so good treatment and prevention are needed. Several studies suggest that there is a correlation between hypertension risk factors and the disturbance of sleep quality. Therefore, it is necessary to develop preventive and promotive efforts to obtain optimum blood pressure in patients with hypertension to avoid complications or even death. This study aims to find out the correlation between sleep quality and the value of blood pressure in the elderly ?60 years old in Batu City. A cross-sectional study was conducted in Batu City in 2020. Stratified random sampling was performed to select the respondents. A validated PSQI questionnaire and sphygmomanometer were used to assess sleep quality and blood pressure, respectively. A Chi-Square test was used to test the hypothesis. There were 391 respondents involved in this study. Most of the respondents have poor sleep quality, 205 respondents (52,43%) of which 41 respondents (20%) have normal blood pressure, and 164 respondents (80%) have high blood pressure. The statistical analysis shows a significant correlation (p=0,000) between sleep quality and blood pressure. In conclusion, hypertension is associated with poor sleep quality in the geriatric population in Batu City.

This study aimed to determine the role of the soluble costimulatory molecules in aging and the association with the presence of comorbid in aged individuals. Thirty-two elderly and twenty healthy subjects were included in this study. The soluble costimulatory molecules sCD28, sCD80, sCD86, sCD163, and sCTLA4 were measured using ELISA. The presence of comorbid was documented from medical records. Charlson Comorbidity Index (CCI) was measured to evaluate the survival/mortality risk for the subjects. The levels of the majority of soluble costimulatory molecules significantly increased in the elderly participants, while the level of sCD86 was comparable. There were weak positive correlations between the subject's age and levels of sCD28 (R=0.214, p=0.048), sCTLA4 (R=0.238, p=0.041), and sCD80 (R=0.317, p=0.012). sCD80 were discovered to be the best to predict immune aging in the elderly with AUC 0.71 [0.57-0.86], sensitivity 53,1%, specificity 80.0%, and cut off 129ng/ml. Most of the elderly participants had at least one comorbid, in which approximately 25.0% and 3.1% of the subjects were classified as mild and moderate CCI. Multivariate analysis showed that comorbidities in elderly individuals have been associated with levels of sCTLA4 ≥26.5ng/ml and sCD80 ≥129.0ng/ml. Furthermore, subjects with comorbid (CCI ≥1) were associated with sCD80 ≥129.0ng/ml (OR 12.44 [95% CI 1.32–117.03], p=0.027). Considering these results, sCD28, sCTLA4, and sCD80 can be developed as biomarkers for predicting immune aging and elderly comorbidities, respectively.