Background: Dengue is a disease related to the environment that spreads rapidly. Prevention movement is considered ineffective; therefore, a more efficient early warning system is required. It is required strongly correlated variables to as predictor in early warning system. This study aims to identify the environmental conditions associated with dengue. Materials and methods: This ecological study was conducted on five sub-districts selected based on the trend of the incidence. Data land cover and elevation obtained using GIS. Climate data were obtained from Meteorology and Climatology and Geophysics Agency of Yogyakarta. Results: There were 1.150 dengue cases from 2008-2013 obtained from District Health Office. The spatial pattern is clustered in all sub-districts (Z-score < -2.58). There is a positive correlation between land cover and dengue (p 0.000; r 0.284) and a negative correlation between elevation areas and dengue (p 0.000; r -0.127). Multiple Regression Test shows the effect of humidity (p 0.000) and rainfall (p 0.002) with a contribution of 13.5% -27.4% (r 2 0.135 -0.274), while temperature has no effect in all sub-districts (p > 0.05). There is no effect of climate parameters in sporadic dengue areas (p > 0.05). Conclusion: It is concluded that dengue in Sleman is clustered and associated with the environment parameter, even though it does not have close correlation. High elevated and small building area is consistent with the lower dengue cases. Humidity and rainfall affect dengue, but temperature does not affect dengue.

Aim:To assess the factors defining healthcare-seeking behavior of people with musculoskeletal pain in the urban community of Malang City, East Java, Indonesia. Methods:A cross-sectional survey was performed in Malang City, East Java, Indonesia. In total, 2067 participants aged 16-93 years were interviewed. The sociodemographic and socioeconomic factors of healthcare seeking behavior, musculoskeletal pain, disability, and adverse drug reactions were assessed using the validated Indonesian version of Community Oriented Program for the Control of Rheumatic Disease (COPCORD) protocol by International League of Associations forRheumatology and the World Health Organization core questionnaire. Chi-square test was applied to assess the determinants of health-seeking behavior for musculoskeletal pain.Results: Slightly more than one-third of the respondents (36%) with musculoskeletal pain, described as osteoarthritis, low back pain, gouty arthritis, soft tissue rheumatism, and autoimmune arthritis, were assessed for their health-seeking behavior.About 73% of all those participants sought treatment for their musculoskeletal symptoms. Treatment modality used was modern healthcare, traditional healthcare, selftreatment using traditional medication, self-treatment using modern medication with the proportions of 20.94%, 25.23%, 33.95%, 25.77%, respectively. Disability significantly affected health-seeking behavior as the major determinant (prevalence ratio[PR] 1.087, 95% CI 1.031-1.146, P = 0.002), followed by age (PR 1.043, 95% CI 1.000-1.087, P = 0.049). Healthcare-seeking behavior was associated with the presence of adverse drug reactions (P < 0.001). Conclusion:Factors associated with musculoskeletal pain health-seeking behavior were disability and age. Self and traditional healthcare treatment were further associated with an adverse drug reaction. K E Y W O R D Sadverse drug reaction, COPCORD, health seeking behavior, musculoskeletal pain

Keberhasilan tindakan dan peningkatan outcome pada stroke sangat bergantung pada kecepatan pasien dibawa ke instalasi gawat darurat namun sebagian besar pasien stroke iskemik akut datang terlambat. Tujuan penelitian ini adalah untuk mengetahui pengaruh pengetahuan tentang faktor risiko dan peringatan gejala stroke terhadap keterlambatan kedatangan pasien post serangan stroke iskemik akut di instalasi gawat darurat di RSUD Ngudi Waluyo Wlingi. Desain penelitian yang digunakan adalah cross sectional. Pengumpulan data dilakukan dengan memberikan kuesioner pada anggota keluarga pasien stroke iskemik akut yang dipilih secara consecutive sejumlah 58 orang dengan pertimbangan mengetahui dan terlibat langsung membawa pasien ke instalasi gawat darurat. Analisis data dilakukan dengan menggunakan analisis univariat dan regresi linier berganda untuk mengetahui pengaruh pengetahuan terhadap keterlambatan. Hasil penelitian menunjukkan rata-rata skor pengetahuan responden adalah 8,55±SD 4,551 dan koefisien korelasi-0,303 (p=0,041). Dapat disimpulkan bahwa pengetahuan tentang faktor risiko dan peringatan gejala stroke menurunkan keterlambatan kedatangan pasien post serangan stroke iskemik akut.

Background: The knowledge about stroke risks and early symptoms is pivotal to minimize the arrival delay in the hospital and maximize the effective treatments. Objective: Investigating the factors affecting the knowledge about stroke risks and early symptoms in emergency department (ED). Methods: The study employed cross sectional design by means of prospective approach. Samples were taken by consecutive sampling technique recruiting in total of 58 respondents. The respondents were the family or relatives of acute ischemic stroke patients who happened to know and directly involved in taking the patients to the ED. Data analyzed by utilizing univariate analysis, independent ttest, and one-way ANOVA to determine the differences in the knowledge of every respondent based on several characteristics. Multivariate analysis was used to investigate the factors affecting the knowledge about stroke risks and early symptoms. Results: The average age of the 58 respondents was 34-57 years old. 46.5% of whom were graduating from primary school; 51.7% have never been equipped with the necessary information about stroke; 55.2% are female; and 50% of whom were unemployed. There were differences in the knowledge about stroke risks based on the prior information about stroke and education background. As for stroke early symptoms, there were differences towards occupations, prior information about stroke, and education background. The most affecting factor towards the knowledge of stroke risks is education background (p=0.000); while the knowledge about stroke early symptoms was mostly affected by prior information about stroke (p=0.012) and education background (p=0.000). Discussions : Most respondents were less equipped with the necessary knowledge about stroke risks and symptoms. The respondents' knowledge about stroke risks and early symptoms was considered less, while education background was the affecting factor towards the knowledge about stroke risks and symptoms.

Coronary heart disease (CHD) is a non-transmitted disease which is particular concern at the global, national, and local level. CHD has become a concern because it has caused a lot of deaths. Risk factors linked with CHD consist of permanent risk factors and variable risk factors. The purpose of the research is to analyze the correlation between variable risk factors and CHD in the Minahasa ethnic society in Manado City. This research was an observational casecontrol study conducted by Prof. dr. R. D. Kandou Hospital, Manado, from August to October 2016. In total, there were 220 patients included. The sampling used a simple random sampling method and the data obtained were analyzed by chi-squared test. According to the results, hypertension, smoking, and behavioral type were connected to cases of CHD. The correlation degree showed that the respondents suffering hypertension were 5.70 times more likely to suffer CHD, the smoking respondents were 2.25 times more likely to experience, and behavior type A respondents were 2.96 times more likely to suffer CHD. Hypertension, smoking, and behavioral type are linked with CHD, so there should be some promotion and preventive actions from the health governmental institution to society, especially aimed at adults, about the quality of life enhancement by healthy behavior and avoiding CHD risk factors.

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Our data indicate that darapladib can decrease the foam cells number, iNOS, and ICAM-1 expression in aorta at the early stages of atherosclerosis in T2DM rat model.

Mapalus is a form of traditional mutual assistance inherited within ancestors in the land of Minahasa. Mapalus has become such a coding for Minahasa ethnic. The implementation of Mapalus has taken place in various aspects ranging from agriculture, social, community, politics, security and health. In the field of health, there has never been a study of the effect of the implementation of Mapalus tradition on the incidence of a disease, especially coronary heart disease (CHD). This study was conducted through qualitative approach. The results obtained that the implementation of Mapalus values is still done by the ethnic communities of Minahasa, and these values affect the incidence of CHD in Minahasa.