Background<br />Coronary heart disease (CHD) ranks second after diabetes mellitus (DM) based on hazard rate, and after stroke (based on number of deaths caused). Our aim was to determine the risk factor and magnitude of CHD among adults. <br /><br />Methods <br />A cohort study on risk factors of non-communicable diseases (CS-RFNCD) was conducted on subjects aged ≥25 years. Initiated by screening, follow-up (FU) was done 3 times yearly and complete health examination every 2 years. CHD cases screened by electrocardiographic examination on subjects aged ≥40 years and <40 years with history of hypertension and/or heart disease. Screening results found 840 of 5690 subjects with CHD diagnosis who were excluded from cohort study sample. Non-CHD subjects and those aged <40 years without a history of hypertension and/or heart disease, totalling 4840 people, were included in study sample and followed up for 6 years. Data were analyzed using Cox regression.<br /><br />Results<br />Carbohydrate intake of ≥60% of total energy had a 2.8-fold higher CHD risk [HR=2.790; 95% CI: 1.962 - 3.967; p=0.000] than that of an intake of <60% of total energy. Age of ≥55 years had 2.6-fold higher CHD risk [HR=2.573; 95% CI: 1.803 - 3.671; p=0.000] than age of <55 years. Blood total cholesterol of <span style="text-decoration: underline;">≥</span>200 mg/dL had 1.9-fold higher CHD risk [HR=1.893; 95% CI: 1.319 - 2.715; p=0.001] than that of <200 mg/dL.<br /><br />Conclusion<br />Higher intake of carbohydrate increases CHD incidence among adults. Efforts in controlling CHD risk factors are still needed especially in consumption behavior through a family approach.
Background<br />Injuries due to traffic accidents are the leading cause of death and disability, especially in developing countries. The proportion of injuries in Indonesia tends to increase. The cause of the injury is dominated by motorcycle accidents (70-85%). The aim of this study was to compare the severity of motorcycle injuries with that of other land transportation injuries in Indonesia. <br /><br />Methods<br />A study of a cross-sectional design was performed involving 15,849 subjects from 33 provinces in Indonesia. The dependent variable was the severity of injury and the main independent variable was transportation mode (motorcycle and other vehicles). Other independent variables included were respondent characteristics (sex, age, education, occupation, economic status) and health status (stroke, hypertension, heart disease, impaired hearing and vision). Chi-square test and multiple logistic regression were used to analyze the data.<br /><br />Results<br />The contribution of motorcycle transportation mode to the severity of the injury was 85.5%. The proportion of severity of injury due to motorcycle transportation was higher (9.0%) than to other land transportation modes (7.5%). The severity of injuries related to motorcycle transportation was 1.1 times greater (AOR=1.1 95% CI 1.0-1.3) than that other related to vehicles. The determinants of severity of injury due to motorcycle transportation were age and sex.<br /><br />Conclusion <br />Motorcyclists are at higher risk of having injuries than persons using other modes of transportation. Motorcyclists need to increase the safety of riding and to be more discriminating in the selection of the safest mode of transportation, by taking age and sex into consideration.
Background<br />In Indonesia, the prevalence of injury has increased from 7.9% in 2007 to 8.2% in 2013. Among older persons, falls were the main cause of injury. The objective of this study was to determine the major risk factors and the magnitude of the risk for fall-related injury in older persons.<br /><br />Methods<br />A study of cross-sectional design was conducted on 4,222 respondents aged 60 years and over. Injury was defined as fall-related injury occurring in the previous 12 months that disturbed activity dailyu living (ADL). Data collection was done by: 1) interview about sociodemographics and health (including hearing impairment, non-communicable diseases and injury) using a questionnaire, 2) measurement of blood pressure and anthropometry (body mass index), 3) examination of vision in the right nd left eyes using tumbling E cards and pinhole eye covers. Data were analyzed using the chi square test and multiple logistic regression with 0.05 significance level.<br /><br />Results <br />After controlling for age, occupation, vision disorder, educational level and economic status, older women had a 2.0-fold increased risk for fall-related injury compared to men (aOR=2.30; 95% CI: 1.93-2.73; p=0.000); subjects with a history of stroke had a 2.0-fold increased risk for fall-related injury compared to those without a history of stroke (aOR=2.07; 95% CI: 1.38-3.09; p=0.000). Educational level was a confounding factor.<br /><br />Conclusion<br />Women and stroke sufferers were at higher risk of fall-related injury among older persons. Prevention of fall-related injury should be done by older persons through periodic control of their health condition.
<p>Background<br />In Indonesia, cancer prevalence according to the Basic Health Research 2013 was 1.4 per 1000 inhabitants and the most common cancer in hospitalized patients in 2010 was breast cancer (28.7%). Hormonal contraception (HC) use increases the breast cancer risk, even though HC has been used by 210 million women in the world. We aimed to define the association of HC with breast tumors based on clinical breast examination (CBE).</p><p>Methods<br />A case-control design using secondary data from the baseline of the Cohort Study on the Risk Factors of Non-Communicable Disease (RFNCD) in 2011-2012 in 5 villages in Central Bogor District, Bogor City. Samples consisted of 152 cases and 152 controls. Cases comprised palpable tumors in one or both breasts CBE (+). Controls had no tumors in both breasts /CBE(-). Data were analyzed by logistic regression.</p><p>Results<br />Odds Ratio (OR) of CBE + was 1.83 (95% CI: 1.11-3.04; p=0.019) for HC user and 1.62 (95% CI: 1.01-2.60; p=0.044) for blood total cholesterol level <200 mg/dL. OR of group CBE(+) was 1.01 (current smoking) and 0.49 (former smoking) compared with nonsmoking (p=0.082); OR was also 1.21 for subjects with one child and 1.77 for those without children, compared with those who had ³2 children (p=0.454).</p><p>Conclusion <br />Hormonal contraception use increases breast tumor risk 1.8-fold after controlling for total cholesterol, smoking status and parity. With the several limitations of this advanced analysis, investigations focused on types and duration of HC use are still necessary.</p>
BACKGROUNDDyslipidemia is of global occurrence, with a prevalence 30% or higher in several countries, including Indonesia. One risk factor of dyslipidemia is physical or mental stress, that is more frequent in women. This study aimed at investigating the association between psychological distress and dyslipidemia in adult women. METHODSThis observational longitudinal study involved 1850 women aged 25 years and older at baseline. Dyslipidemia was determined from the ratio of low- density lipoprotein to high-density lipoprotein. Psychological distress was determined using the 20-item self-reporting questionnaire. Data analysis was by Cox regression for calculating the hazard ratio of the incidence of dyslipidemia as predicted by the psychological distress. RESULTSAmong the 1474 participants without dyslipidemia at baseline, 545 (36.9%) developed dyslipidemia during 6 years of monitoring, while 93 (6.3%) had a history of psychological distress. There was a significant association between psychological distress and dyslipidemia (HR = 3.08; 95% CI: 2.33- 4.07). Cox regression revealed that the association was still found to be significant after a further adjustment for the variables of age, BMI, menopause, smoking status, physical activity, and carbohydrate and fat intakes (HR=2.8; 95% CI: 2.10 - 3.77). CONCLUSIONSDyslipidemia incidence was high among adult women in Bogor. Women with psychological distress had higher incidence rates of dyslipidemia than women without psychological distress. Psychological distress in women was statistically significantly associated with incidence rate of dyslipidemia. This finding highlights the importance of the need for a dyslipidemia- reduction program in women through prevention and control of psychological distress.
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