Journal of Public Health and Development

Combination of Warm Sitz Bath Therapy and Boiled Taumo Leaves (Blumea Balsamifera) on uterine involution in postpartum mothers: quasi-experimental study

Thu, 29 Jan 2026 00:00:00 +0700

In East Asia and the Pacific region, the leading causes of maternal mortality are hemorrhage, sepsis/infections, obstructed labor, and hypertensive illnesses. To analyze the effect of a combination of warm Sitz Bath therapy and boiled taumo leaves (Blumea balsamifera) on uterine involution in postpartum mothers. This quasi-experimental study used a pre- and post-intervention group design. The population in this study was all postpartum mothers in North Konawe Regency with a sample size of 196 mothers consisting of two groups, namely mothers who were given sitz bath therapy alone and mothers who were given a combination of sitz bath and taumo leaf decoction. The intervention will be carried out for 20 min every day for 3 days, and an evaluation will be carried out every day for uterine involution. Mann–Whitney U and Wilcoxon signed-rank tests were used for the analysis. In the intervention group, there was a decrease in Uterine Fundus Height on days 1–2 and 1–3, with p-values of 0.001 and 0.000, respectively. A decrease in Uterine Fundus Height also occurred in the control group on days 1 to 2 and days 1 to 3, with p-values of 0.003 and 0.002, respectively. The analysis revealed significant differences in uterine fundus height during the first three days postpartum. These findings emphasize the importance of closely monitoring these parameters for optimal maternal and neonatal outcomes.

Financial risk and decision-making strategies for lung cancer: insights from Northern Thailand

Apicha Insuwan, Natharin Phattayanon — Thu, 29 Jan 2026 00:00:00 +0700

Lung cancer remains a significant health issue in Northern Thailand, driven by socio-economic factors and environmental pollutants that negatively impact patient outcomes. This study explores the relationship between financial risk, treatment accessibility, and survival rates among lung cancer patients. A total of 290 patients were analyzed concerning their demographics, treatment methods, financial burdens, and outcomes. Utilizing logistic regression and decision curve analysis, a prediction model for financial burden risk was developed, achieving an accuracy of 85.42%, with a sensitivity of 81.82%, and a specificity of 77.97%. Key factors contributing to financial toxicity included irregular income, prior financial difficulties, and inadequate reserve funds. Recommendations for managing patients based on financial risk categories are provided. Low-risk patients can benefit from financial counseling, affordable treatment options, and regular evaluations to mitigate unexpected expenses. Those classified as intermediate risk require timely financial planning, access to support services, and the optimization of healthcare coverage. High-risk patients should receive intensive encouragement through financial assistance programs, multidisciplinary care teams, and palliative care options to alleviate economic stress. The findings highlight the necessity for improved financial assistance policies and integrated care strategies that address financial security, promote environmental wellness, and foster community support, ultimately enhancing treatment adherence and patient outcomes.

Analysis of determinants of stunting among children under five years using curve analysis of receiver operating characteristics

Thu, 29 Jan 2026 00:00:00 +0700

Stunting in children is still a global public health issue. Compared to other middle-income nations, Indonesia has one of the highest rates of stunting, and Bandung City is one of the worst affected areas in the country. The purpose of this study is to analyze the determinants of stunting and identify predictive indices of stunting incidence in children aged 12-59 months using curve analysis of receiver operating characteristics. In Bandung City, 400 participants (200 cases and 200 controls) participated in a case-control study. Simple random sampling and proportional sampling methods were used to draw samples. Data were gathered by anthropometric measurements and interviews using structured questionnaires. Predictive indices were determined using receiver operating characteristic analysis and the multiple logistic regression test. A history of infectious disease (p=0.003, OR=2.524, 95% CI=1.361-4.683), not being exclusively breastfed (p=0.020, OR=1.929, 95% CI=1.109-3.356), incomplete immunization history (p=0.0001, OR=4.703, 95% CI=2.747-8.052), inadequate drinking water source (p=0.0001, OR=2.587, 95% CI=1.543-4.337), and birth spacing < 24 months were all associated with stunting. According to the receiver operating characteristics study, the stunting prediction index may identify toddlers who are actually stunted by 31.0% of the stunted population, with a Sensitivity (0.31) and Specificity (0.31) value. The risk of stunting is 93.2% if the child is born less than 24 months apart from a sibling, is not breastfed exclusively, has an incomplete immunization history, has a history of infectious diseases, and the drinking water source does not satisfy the necessary standards. Therefore, in order to combat malnutrition, policymakers and stakeholders are advised to enhance prevention and promotion strategies during the prenatal, antenatal, and postnatal phases.

Perceptions, attitudes and expectations of the public towards primary health care services in sub-district health promoting hospitals, Suphanburi Province, Thailand

Nopadol Thongaram, Kanokporn Somporn, Sutthisak Surirak — Thu, 29 Jan 2026 00:00:00 +0700

Primary healthcare services are essential for the development of public health, particularly in Thailand, where Sub-district Health Promoting Hospitals function as primary care units. With the planned transfer of these facilities to the Suphanburi Provincial Administrative Organization, understanding public perspectives is crucial for improving services. This study aimed to examine the relationships between utilization behavior, public perceptions, attitudes, expectations, and the factors influencing primary healthcare service utilization. This cross-sectional analytical study involved 454 participants aged 20 years and above who were registered users of Sub-district Health Promoting Hospitals in Suphanburi Province. Data collection was conducted using a validated questionnaire measuring perceptions, attitudes, expectations, and healthcare service utilization behavior. Statistical analysis included descriptive statistics, Pearson's correlation coefficient, and stepwise multiple regression analysis. The results showed that the majority of participants were female (66.70%), aged 20–35 years (44.90%), and married (48.7%). Service recipients demonstrated a moderate level of perception (M=79.63, SD=11.92), a high level of attitude (M=81.50, SD=12.18), and a moderate level of expectation (M=62.15, SD=9.14) toward primary healthcare services. Primary healthcare service utilization behavior was also at a moderate level (M=74.82, SD=14.75). Significant positive correlations were found between healthcare service utilization behavior and attitudes (r=0.52, p<.01), perceptions (r=0.49, p<.01), and expectations (r=0.47, p<.01). The three predictors collectively explained 28.7% of the variance in healthcare-seeking behavior (Adjusted R²=0.287, p<.05).

These findings highlight that public perceptions, attitudes, and expectations significantly influenced primary healthcare service utilization behavior. The study suggests the need for action research involving stakeholders to enhance service quality in primary healthcare units during the administrative transition period.

School adjustment of ethnic minority students in Chiang Rai, Thailand

Rattanaporn Arsa, Natthani Meemon, Aungsumalee Pholpark, Patreeya Kitcharoen — Thu, 29 Jan 2026 00:00:00 +0700

This study investigates the school adjustment of ethnic minority students in Chiang Rai, Thailand, focusing on three dimensions: social engagement, academic achievement, and psychological well-being. Using Bronfenbrenner’s ecological systems theory, this study shows how both individual and wider social factors affect how ethnic minority students adjust to school. Employing a cross-sectional survey design, data were collected from 404 students in three districts: Chiang Saen, Chiang Khong, and Wiang Kaen. The participants were drawn from diverse ethnic groups, including Hmong, Tai Yai, Lahu, Akha, and others. The findings indicated that 56.2% of the students demonstrated moderate levels of school adjustment, while 43.8% showed good adjustment. Among the dimensions, academic achievement scored the highest, followed by social engagement, with psychological well-being rated as the lowest. The study identified school stress and academic management as significant predictors of school adjustment, collectively accounting for 29.3% of the variance. School stress emerged as the strongest predictor, highlighting its critical impact on students’ ability to adapt to the school environment. The findings provide useful guidance for policymakers, educators, and other stakeholders in developing interventions that respond to the unique challenges experienced by ethnic minority students. Such initiatives should aim to create a more inclusive and supportive educational environment that promotes social integration, academic success, and psychological well-being.

Analysis of factors influencing the willingness of primary healthcare visit among Jiangsu Residents Based on Andersen Model

Wenjun Yan, Vorapoj Promasatayaprot, Glangkarn Sumattana — Thu, 29 Jan 2026 00:00:00 +0700

Primary healthcare services are of great significance for the protection of residents’ health. The aim of the present study is to explore additional factors influencing the Primary healthcare visit among community residents, based on the Andersen model for health service utilization. A combination of cluster and convenience sampling methods was employed to survey 424 urban and rural residents in Jiangsu Province and to analyze the factors influencing residents' utilization rate of Primary healthcare services. The instrument used was a questionnaire based on the Andersen Model as the theoretical framework. Qualitative variables were analyzed using the chi-square test, and quantitative variables were analyzed with the Mann-Whitney U test. Univariate analysis was conducted. The results showed a willingness of residents’ primary healthcare visit rate of 52.6% among residents, with influencing factors being place of gender (P=0.002), education level (P=0.022), residence (P<0.001), monthly medical expenditure (P=0.004), distance from home to the large hospital (P=0.031) and whether the primary level hospital equipment should be improved (P=0.049). Then, Variables with a P-value lower than 0.25 in univariate analysis were taken as independent variables. Logistic regression analysis identified gender (OR=1.812), residence (OR=2.041), whether the primary level hospital equipment should be improved (OR=1.824) and whether the responsibility of primary care doctors is to conduct regular physical examinations for residents (OR=0.590) as the main influencing factors. This study provides a scientific basis for optimizing primary healthcare services and suggests that the future health reforms in China should focus on the quality of rural primary healthcare services.

Spatial autocorrelation analysis of diarrhea incidence in Bandung City, Indonesia in 2024

Thu, 29 Jan 2026 00:00:00 +0700

Diarrhea remains a significant public health issue worldwide. The World Health Organization (WHO) estimates that diarrhea accounts for approximately 1.7 billion cases annually, making it a leading cause of child mortality. The morbidity rate for diarrhea in Bandung City across all age groups was 25 per 1,000 population in 2019. This study analyzes the spatial autocorrelation of diarrhea incidence in Bandung City, Indonesia, using Moran’s index. A retrospective spatial analysis was conducted on 896 diarrhea cases recorded at Harapan Bunda Hospital, Bandung, from January 1 to June 30, 2024. Spatial autocorrelation was assessed using Moran’s I, with spatial units defined at the district level. The analysis incorporated ICD-10 classifications, including A06 (amoebiasis), A09 (diarrhea and gastroenteritis due to infectious causes), and O99.6 (digestive diseases complicating pregnancy). The results of autocorrelation were as follows: mild or some dehydration by age (Moran’s I = 0.396, p = 0.001), unspecified amoebiasis (Moran’s I = 0.421, p = 0.000), amoebiasis (Moran’s I = 0.508, p = 0.000), diarrhea and gastroenteritis of presumed infectious origin (Moran’s I = 0.450, p = 0.000), unspecified dehydration status by age (Moran’s I = 0.302, p = 0.000), digestive system diseases complicating pregnancy, childbirth, and the puerperium (Moran’s I = -0.450 , p = 0.000). These findings indicated a clustered distribution pattern, suggesting that diarrhea incidence in one location correlates with cases in surrounding locations. This study recommends targeted interventions for high-risk clusters, such as community-based health programs and environmental sanitation improvements.

Analysis of medication demand forecasting using single exponential smoothing method based on consumption patterns at Bali Mandara Hospital, Indonesia

Ni Putu Vyra Ginanti Putri, Chairun Wiedyaningsih, Endang Yuniarti — Thu, 29 Jan 2026 00:00:00 +0700

Drug planning requires accurate forecasting to determine the right type and amount of drugs. The Single Exponential Smoothing (SES) method is used in this study due to its ability to produce more accurate forecasts than other methods. Drugs are classified based on consumption patterns into Smooth, Intermittent, Erratic, and Lumpy to evaluate the accuracy of the SES method on each pattern. This descriptive and non-experimental study uses retrospective data from 469 drugs at Bali Mandara Hospital from January 2023 to December 2023. Data were classified based on consumption patterns with CV² and ADI parameters, and forecasting was performed using the Eviews-12 application and evaluated with the MAPE accuracy indicator using Microsoft Excel. The clustering results showed 335 drugs with smooth consumption patterns, three with intermittent consumption patterns, 50 with lumpy consumption patterns, and 81 with erratic consumption patterns. SES gives the best results in a smooth pattern, with 71.43% of forecasts falling into the accurate, good, or reasonable category. The smooth pattern also shows highly accurate (MAPE <10%) and good (MAPE 10%-20%) forecasting rates that are higher than other consumption patterns. This study concludes that drugs categorized as smooth consumption patterns produce more accurate forecasts than other consumption patterns (intermittent, lumpy, and erratic).

The effect of boiled cosmos caudatus leaves on blood sugar levels in elderly patients with diabetes mellitus

Thu, 29 Jan 2026 00:00:00 +0700

In Indonesia, diabetes mellitus is one of the ten most common diseases among the elderly, with North Sulawesi Province having the highest prevalence. Cosmos caudatus leaves contain bioactive components, such as flavonoids and phenolic compounds, which have been shown to be effective in increasing insulin resistance and sensitivity in patients with DM. This study aimed to evaluate the effect of boiled Cosmos caudatus leaves on blood sugar levels in elderly patients with diabetes mellitus at the Bahu Health Center in Manado City. This study used a quantitative approach with a quasi-experiment, one-group pre-test post-test design. Ninety elderly respondents with diabetes mellitus at the Bahu Health Center in Manado City were included in this study. Blood sugar levels were measured before and after the intervention with boiled C. caudatus leaves. The intervention involved administering boiled water prepared from seven Cosmos caudatus leaves twice daily, in the morning and evening, at a dose of 250 ml each time. The findings showed that Cosmos caudatus exhibits a range of nutritional and phytochemical properties that support its use as a functional food. Its composition provides benefits for digestive health, energy provision, and antioxidant protection. There was a significant difference in the blood sugar levels of the respondents before and after the intervention. Statistical analysis showed a p-value of < 0.001. Therefore, it can be concluded that this intervention was significant. Boiled leaves of Cosmos caudatushave been proven to be effective in lowering blood sugar levels in elderly patients with diabetes mellitus.

Moringa oleifera and Phoenix dactylifera L. effects on cortisol and breast milk in postpartum depression: A randomized controlled trial

Melania Asi, Aswita Aswita , Hendra Yulita, Hesti Resyana, Farming Farming — Thu, 29 Jan 2026 00:00:00 +0700

Postpartum depression affects 10-20% of new mothers globally, potentially disrupting breast milk production. This study aimed to provide valuable insights into effective interventions to improve the health and well-being of Postpartum Mothers with depression. This study used a randomized controlled trial design with three groups: intervention 1 (dates), intervention 2 (Moringa oleifera), and a control group. A total of 363 postpartum mothers participated, and data were collected through salivary cortisol levels (ELISA) and Beck Depression Inventory (BDI) scores to measure depression levels and breast milk production (ACIS AC-15X digital scale and Crown electric breast pump) before and after the intervention for 28 days. Data analysis was performed using paired sample t-test and the independent t-test. The findings showed that both intervention groups experienced significant decreases in BDI scores and cortisol levels as well as increased breast milk production. Intervention group 1 showed a decrease in the BDI score from 3 to 1.5 (p < 0.001) and an increase in breast milk production from 159 mL to 471 mL (p < 0.001). Intervention group 2 also showed a decrease in the BDI score from 3.2 to 1.7 (p = 0.003) and an increase in breast milk production from 103 mL to 396 mL (p = 0.007). In conclusion, nutritional intervention with Moringa oleifera and Phoenix dactylifera L. is effective in reducing depressive symptoms and increasing breast milk production in postpartum mothers. The integration of these interventions into maternal health programs may provide a natural and effective solution to address mental health and lactation challenges in the postpartum period.

The influencing factors of protective behaviors among elderly people in Phayao Province, Thailand

Russamee Junkraweekoon, Taweewun Srisookkum, Patipat Vongruang, Somkid Juwa — Thu, 29 Jan 2026 00:00:00 +0700

Particulate matter with a diameter of less than 2.5 micrometers (PM2.5) is an environmental contaminant that significantly impacts the health of the elderly. Therefore, socio-demographic variables, environmental health literacy (EHL), and protective behaviors (PB) are essential factors to examine among the elderly people. This cross-sectional study aimed to assess the levels of EHL and PB, as well as the factors influencing PB related to PM2.5, among elderly individuals. The sample included 626 elderly participants from Phayao Province, a region in northern Thailand affected by PM2.5. Participants were selected using multistage sampling, and data were collected via a questionnaire between February 2024 and April 2024. Descriptive statistics and multiple regression analysis (MRA) were used for data analysis.

The results indicated that the majority of participants were female (54.8%), married (67.7%), had an elementary education (67.7%), had worked in agriculture (32.7%), and had underlying diseases (49.4%). The mean age was 67.2 years, while the mean duration of residence was 51.7 years. The EHL level was low (mean=1.53 out of 5.0 points), whereas PB was moderate (mean=2.27 out of 3.0 points). MRA identified four independent variables that predicted PB: EHL (B = 0.102), occupation (B = -0.886), duration of residence (B = -0.018), and underlying disease (B = -0.539). This study highlights the need for health organizations to prioritize enhancing EHL to promote preventive behaviors, establish EHL programs, and assess EHL and PB among elderly people. Moreover, relevant organizations should develop policies to improve EHL and PB among the elderly in the study area.

Determinants of stunting among children aged 6–23 months in Bandung City: the role of maternal and child health factors

Thu, 29 Jan 2026 00:00:00 +0700

Stunting is a global health problem that impacts children's physical growth, cognitive development, and future economic well-being. In Indonesia, although the prevalence of stunting has decreased, the incidence rate is still high, including in Bandung City. Maternal and child health factors play an important role in the incidence of stunting, but there is limited research on the interaction of these factors in an urban context. This study aims to analyze the influence of maternal and child health factors on the incidence of stunting in children aged 6-23 months in Bandung City. This study used a community-based cross-sectional design, involving 412 randomly selected children aged 6-23 months in Bandung City. The sample was collected using a multi-stage sampling technique. Data were collected through interviews using structured questionnaires and anthropometric measurements. Multivariate logistic regression was used to identify associations between maternal factors, child health, and the incidence of stunting. The prevalence of stunting in Bandung City was 35.0%. Analysis showed that factors associated with an increased risk of stunting included: having less than 4 antenatal visits (AOR=2.23), not exclusively breastfed (AOR=1.38), low birth weight (AOR=1.52), and history of infectious diseases (AOR=3.30). In addition, socioeconomic factors, such as low family income, also contributed significantly to the incidence of stunting (AOR=3.15). A correlation has been demonstrated between maternal and child health factors and the incidence of stunting in Bandung City. Policy recommendations include improving access to and quality of maternal health services, promoting exclusive breastfeeding, and nutrition counselling for low-income families.

Awareness of stroke warning signs and associated factors among community residents in Huanggang, China: A cross-sectional study

Xiangbo Wu, Thidarat Somdee, Suneerat Yangyuen — Thu, 29 Jan 2026 00:00:00 +0700

Stroke is the leading cause of disability and death in China. Despite efforts by the Chinese government to prioritize this public health issue, Chinese residents face significant challenges related to poor awareness of the signs of stroke and delays in seeking treatment. This study aims to explore stroke awareness and associated factors among residents of one community in China. A cross-sectional design was performed on 760 residents in Huanggang, China, selected by the cluster sampling method. A self-administered questionnaire was used for data collection. Multiple logistic regression was applied to investigate factors influencing stroke awareness. The results revealed that most participants were male (65.0%) with a median age of 65 years; more than half (64.7%) had good stroke awareness. After adjusting for other covariates, stroke awareness was significantly positively associated with a history of vascular risk or previous stroke, stroke-related knowledge, stroke prevention behavior, and health belief model (HBM) constructs, including perceived benefits, self-efficacy, perceived susceptibility, perceived severity, and cues to action. However, good stroke awareness was negatively associated with perceived barriers. In conclusion, Huanggang residents had good stroke awareness, influenced by stroke-related knowledge, stroke prevention behavior, the HBM constructs, and other factors. Thus, consideration of these factors is important in developing targeted interventions to help individuals recognize the early symptoms of stroke and improve awareness that such symptoms need to be treated as a medical emergency.

Cyberbullying and its associated factors among junior high school students in Mahasarakham, Thailand

Jetsadaporn Sanwang, Kemika Sombateyotha, Suneerat Yangyuen — Thu, 29 Jan 2026 00:00:00 +0700

Cyberbullying is a public health concern among adolescents, influencing their health, well-being, and academic achievement. In addition, junior high school students are more susceptible to cyberbullying. However, little is known about cyberbullying, and efforts to ascertain its associated factors are scarce among Thai junior high school students. Thus, this study aims to investigate cyberbullying and its contributing factors. A cross-sectional design was conducted with 1,143 students from ten high schools in Mahasarakham Province, Thailand, from August 2023 to March 2024, using multistage sampling methods. The data were collected by a self-reported questionnaire, and multinomial logistic regression was applied to explore factors that influence cyberbullying victimization (CV). About 38.0% of students were female, with a median age of 13 years old. Approximately 50.7% reported a high level of CV, 74.3% had a high risk of internet behaviors, 44.5% were pathological internet users, and 57.1% had received information on preventing cyberbullying. Students who were LGBTQ or female, pathological or maladaptive internet users, and those with a high risk of internet behaviors had a higher CV. Additionally, increased CV was associated with authoritative parenting styles, a low to moderate resilience level, and having not received information on preventing cyberbullying. Students who experienced a higher CV were influenced by several potential factors, e.g., gender, internet behaviors, parenting styles, and resilience. Thus, it is essential to consider these factors when designing individual- or school-based interventions or anti-cyberbullying strategies to address and prevent CV among students.

Keywords: cyberbullying, internet addiction, resilience, victimization

Factors influencing substance-use intentions among undergraduate students in northern Thailand: insights from the theory of reasoned action

Thu, 29 Jan 2026 00:00:00 +0700

Substance use among undergraduate students is a growing concern, particularly in Northern Thailand. This study aimed to investigate factors influencing students’ intentions to use substances and identify key predictors using the Theory of Reasoned Action framework. A cross-sectional survey was conducted with 400 students from the University of Phayao during August–September 2024. Data were collected via self-administered questionnaires, and analyses included Chi-square tests and multiple logistic regression. Participants had an average age of 21 years (SD=1.33); 66.0% were female, and 46.0% reported a history of substance use. Notably, 36.2% expressed an intention to use substances. Factors significantly associated with these intentions included gender (p=0.003), relationship status (p=0.005), history of substance use (p<0.001), attitudes (p<0.001), subjective norms (p<0.001), and knowledge (p=0.003). Logistic regression revealed that subjective norms (Adj. OR=3.39, 95% CI=2.002–5.753, p<0.001) and history of substance use (Adj. OR=3.06, 95% CI=1.865–5.028, p<0.001) were the strongest predictors, collectively explaining 32.0% of the variance in substance-use intentions. The findings underscore the critical role of social influences and prior behavioral patterns in shaping substance-use intentions. Efforts to reduce substance use among students should focus on addressing subjective norms and educating students about the risks associated with substance use. Targeted interventions that consider both social dynamics and individual behavioral history are essential to mitigate this issue effectively.

Impact of occupational health and safety education intervention on the knowledge, attitudes, and practices among palm oil plantation workers in Indonesia

Thu, 29 Jan 2026 00:00:00 +0700

Palm oil plantation workers are exposed to various occupational hazards—physical, chemical, and biological—that can lead to accidents and long-term health issues. This study evaluated the effectiveness of a tailored Occupational Health and Safety (OHS) training program in improving knowledge, attitudes, and practices among workers in a plantation in South Kalimantan, Indonesia. A total of 120 workers participated, divided equally into an intervention group (n = 60) and a control group (n = 60). The intervention involved 15 small-group sessions covering eight key OHS topics, delivered by trained cadres using printed and digital modules. A mixed-methods approach with an intervention and cross-sectional design was employed. Due to non-normal data distribution, the Wilcoxon signed-rank test was used to compare pre- and post-intervention scores. Statistically significant improvements were observed in the intervention group, with knowledge scores increasing from 55.47 to 71.60, attitudes from 61.87 to 68.13, and practices from 17.90 to 21.87 (p = 0.000). The proportion of workers with good knowledge rose from 5.8% to 83.8% (p < 0.001; OR = 84.6; 95% CI: 22.3–320.8), while poor attitudes dropped from 80% to 20% (p < 0.001; OR = 10.0; 95% CI: 4.2–23.8). Good safety practices also increased to 76.5% (p < 0.001; OR = 4.9; 95% CI: 2.0–12.3). In contrast, no significant improvements were observed in the control group (p > 0.05). These findings demonstrate the effectiveness of a context-specific OHS training program in enhancing safety-related behaviors among plantation workers. The study also emphasizes the importance of inclusive implementation strategies, particularly for contract workers and those with limited experience, to ensure equitable benefits. Future research should explore the long-term sustainability of these improvements and investigate organizational factors that may influence the success of OHS interventions.

Implementation of an early warning score system and associated factors in a hospital in Bali, Indonesia: a mixed-methods study

Thu, 29 Jan 2026 00:00:00 +0700

Hospitalized patients are at risk of worsening clinical conditions. This requires the implementation of an early warning score (EWS) for monitoring and standardizing patient safety. This study aimed to explore the implementation of an EWS and its associated factors in a hospital in Bali. This mixed-methods study (exploratory sequential design) began with descriptive qualitative research and continued with a cross-sectional component. The qualitative study involved 14 participants (nurses), and the quantitative study involved 302 respondents (nurses). The qualitative data collection used focus group discussions, and the quantitative study used a questionnaire. The qualitative data were analyzed using thematic analysis. The quantitative data were analyzed using univariate (frequency and proportion), bivariate (chi-square test), and multivariate analysis (binary logistic regression). The qualitative analysis identified three themes: adequate EWS knowledge, poor EWS implementation, and perceived barriers. Quantitative analysis revealed that of the 302 respondents, 74.5% showed good EWS implementation. The factors associated with EWS implementation were knowledge (AOR: 2.26; 95% CI: 1.25–4.08; p=0.007), attitude (AOR: 4.32; CI: 2.39–7.80; p<0.001), and leadership support (AOR: 4.12; CI: 2.28–7.43; p<0.001). Therefore, EWS implementation needs to be improved by conducting seminars and training to gain knowledge and attitude, as well as regular supervision to increase leadership support and minimize implementation barriers.

Prenatal massage in pregnant women in the third trimester to improve maternal sleep quality: quasi-experimental study

Thu, 29 Jan 2026 00:00:00 +0700

The third trimester of pregnancy is marked by significant physiological and psychological changes that often lead to sleep disturbances and adversely affect maternal and fetal well-being. This study explored the potential of prenatal massage as a non-pharmacological intervention to improve sleep quality among expectant mothers during this critical period. This Framework employed a quasi-experimental design utilizing a pretest-posttest control group to investigate the effects of prenatal massage on third-trimester pregnant women in Bima City, conducted from July 2024 to January 2025. A total of 448 participants were selected through cluster sampling and divided equally into an intervention group receiving prenatal massage and a control group following routine health service programs. Data collection involved skilled midwives administering a validated questionnaire, consisting of 10 questions with high content validity (i-CVI > 0.83) and reliability (Cronbach's alpha = 0.82). The Wilcoxon signed-rank test was used for within-group comparisons and the Mann-Whitney test was used for between-group differences. Results indicated a significant improvement in sleep quality within the intervention group, where 96.4% reported good sleep quality post-intervention compared to only 7.1% pre-intervention. In contrast, the control group showed minimal changes, with only 5.4% reporting good sleep quality after the same period. Statistical analyses showed P values (0.000 and 0.002 respectively), confirming the significant effectiveness of the intervention. These findings suggest that integrating prenatal massage with prenatal care can enhance the well-being of pregnant women. Overall, this study underscores the importance of addressing sleep quality in prenatal care.

Effectiveness of an educational and motivational program on food label comprehension skills and use among first-year pharmacy students at Khon Kaen University: a randomized controlled trial

Puntitra Pucummee, Tipaporn Kanjanarach, Sutin Chanaboon — Thu, 29 Jan 2026 00:00:00 +0700

Online education has become an increasingly important tool for promoting health behaviors, especially among adolescents who are at risk due to poor dietary choices. In Thailand, despite the presence of food labeling systems, many young consumers lack the knowledge and motivation to use them effectively. This study evaluated the effectiveness of an online educational and motivational program aimed at promoting behavioral skills in food label comprehension and food selection and the behavior of using food labels to select food products. A randomized controlled trial was conducted involving fifty first-year students aged 18-20 years old from the Faculty of Pharmaceutical Sciences, Khon Kaen University, Thailand. The participants were randomly allocated to experimental (n=25) or control (n=25) groups. The intervention comprised a 3-minute motivational video and an e-book focusing on knowledge specific to promoting food label reading behavior. Both groups initially exhibited fair levels of knowledge, high levels of motivation, fair skills, and a tendency to occasionally read food labels. After the intervention, the experimental group demonstrated significantly higher scores in knowledge (from 10 to 13 out of 16), motivation (shifted from high to very high, score 3.93 to 4.25 out of 5), and frequency of label reading (shifted from occasional to frequent, score 3.00 to 4.00 out of 5). However, no substantial change in food label comprehension or selection skills was observed, possibly due to the short intervention period. This study demonstrates the potential of online interventions in enhancing knowledge and motivation regarding nutritional label reading among university students. Future research should evaluate the effectiveness of such interventions across diverse student groups.

Indirect costs and related factors for patients with non-small cell lung cancer treated with targeted therapy in Vietnam

Chinh Van Nguyen, Huong Tran Thi Thanh, Kiet Tuan Pham Huy — Thu, 29 Jan 2026 00:00:00 +0700

The objective of our study was to estimate indirect costs and identify the factors affecting them. Additionally, we aimed to determine which age group impacts the component costs of the total indirect costs for non-small cell lung cancer (NSCLC) patients treated with targeted therapy. This cross-sectional descriptive study was conducted through interviews about indirect costs for one month, from October 2022 to December 2023, with 310 NSCLC patients at the Vietnam National Cancer Hospital. All indirect costs were standardized according to the Consumer Price Index (CPI) and converted to 2023 US dollars. The monthly mean total indirect costs for NSCLC patients were $96.0. The rate of caregivers' absence from work was 49%, and 37.7% of patients experienced income loss. However, the highest cost was income loss at $83.3, accounting for 86.8%, while caregivers' absence cost $10.1, accounting for 10.6% of the total indirect costs. The costs of patients’ absence and income loss were higher for patients under 60 years old (p < 0.001 for each group). Factors such as age (under 60), gender (male), and occupation (employed or unemployed) were identified as related to an increase in the total indirect costs for NSCLC patients compared to other groups (p < 0.05 for each group). Support from insurance agencies for patients’ absence and income loss is truly meaningful.

Sleep quality in non-hospitalized medical students after COVID-19 infection in Northern Vietnam

Thao Thi Thu Nguyen, Thinh Cuong Dao, Binh Thi Thanh Nguyen, Duc Cap Minh — Thu, 29 Jan 2026 00:00:00 +0700

Sleep disorders are among the most commonly reported symptoms following a coronavirus disease 2019 (COVID-19) infection. Medical students, in particular, are highly vulnerable, exhibiting a higher prevalence of poor sleep quality compared to the general population. This study aimed to compare sleep quality between medical students with and without a history of COVID-19 infection and to identify factors associated with poor sleep quality in the infected group. A cross-sectional study was conducted among medical students at a university in Northern Vietnam, with data collected via an online self-administered questionnaire. Sleep quality was assessed using the Sleep Quality Scale (SQS), where higher scores indicate poorer sleep quality. Univariate and multivariate linear regression analyses were performed. Of the 673 participants, 372 (55.3%) had a history of COVID-19 infection, while 301 (44.7%) did not. Students with a history of COVID-19 infection demonstrated significantly poorer sleep quality compared to those without (p < 0.01). Among the infected group, poorer sleep quality was significantly associated with younger age (coefficient [coef]: -1.01; 95% confidence interval [CI]: -1.74 to -0.27), female gender (coef: 3.05; 95% CI: 0.11 to 6.00), living with others (coef: 3.12; 95% CI: 0.42 to 5.81), and a longer duration of COVID-19 infection (coef: 6.84; 95% CI: 2.21 to 11.47). These findings underscore the significant burden of sleep disorders among medical students following COVID-19 infection and highlight the importance of early detection and intervention to mitigate long-term consequences.

The social support needs of older adults within the context of sexually transmitted infections or diseases (STI/STD): A scoping review

Mark Stephan FELIX, Patreeya KITCHAROEN, Thi Ngoc Phuc LE, Haihu GUO — Thu, 29 Jan 2026 00:00:00 +0700

Sexual health among older adults is often overlooked despite evidence that they remain sexually active and at risk for STI/STD infections. The increasing prevalence of these infections in aging populations highlights the importance of understanding their social support needs, especially in mitigating stigma and discrimination. This scoping review aimed at mapping out the relevant extant literature on the subject of the social support needs of older adults who had contracted STI/STD within the context of stigma and discrimination, identified research gaps based on the extracted data and suggested directions for future research. Guided by the PRISMA-ScR guidelines, searches in five international English Language databases including PubMed, SAGE Journals, ScienceDirect, Taylor & Francis Online, and Wiley Online Library yielded 193,874 initial results; four rounds of exclusion guided by the PRISMA-ScR guidelines produced six finalized articles. The analysis of the extracted data identified four main gaps in the extant literature: current research focuses only on HIV; methodological gaps; the roles of family/culture/ethnicity in providing social support; and challenges in maintaining social/spiritual/religious connections. Future research needs to utilize more diverse research methods, include assessments of preparedness and evaluation of social support needs for sexually active older adults; expand research from cultural, ethnic and sociodemographic perspectives; and fourth, augmentation of research in the area of STI/STD among older adults to include gonorrhea, syphilis, chlamydia and Hepatitis C. The findings highlight the critical need for expanded research into the broader spectrum of STI/STD infections among older adults beyond HIV.

Navigating retatrutide safety: comprehensive insights from systematic review and meta-analysis

Thu, 29 Jan 2026 00:00:00 +0700

Retatrutide, a triple agonist (GIP, GLP-1, glucagon receptors), has shown promise in glycaemic control and weight loss, but its safety profile has not been studied in earlier studies. This study aims to systematically evaluate the safety profile of retatrutide by analyzing the incidence and risk of treatment-emergent adverse events. Through a comprehensive review of existing literature, the study seeks to quantify the relative risk of adverse effects, to inform clinical decision-making and future research directions. A systematic literature review following PRISMA 2020 guidelines was conducted across PubMed, Google Scholar, and Science Direct, focusing on studies investigating retatrutide's safety, and we excluded other studies (systematic reviews, narrative reviews, meta-analyses, etc.). Adverse event data, including treatment-emergent adverse events, were pooled and analysed for frequency and risk estimation. A total of 1,331 studies were initially identified, and after applying stringent inclusion and exclusion criteria, four studies were included in this Meta-analysis. We found that retatrutide significantly increased the incidence of adverse events compared to placebo (RR 1.87; 1.25, 2.80; p=0.003), with gastrointestinal disturbances (Nausea, decreased appetite, vomiting, constipation, etc.) being the most common. No significant difference in serious adverse events was observed (RR 0.81; 0.36, 1.83; p=0.61). Adverse events of special interest, such as hypersensitivity and pancreatitis, were notably higher in the retatrutide group (RR 2.94; 1.85, 4.69; p<0.00001). Retatrutide is effective for glycemic control and weight loss, but it increases the incidence of treatment-emergent adverse events, especially gastrointestinal issues, hypersensitivity, and pancreatitis. While serious adverse events were not significantly higher, careful patient selection, dose titration, and monitoring are crucial for patients with GI disorders, hypersensitivity, hepatic disease, cardiac disease etc. Clinicians should assess risks, particularly in vulnerable patients. Future research should explore the long-term safety of retatrutide and compare it with other therapies to refine treatment strategies and improve clinical decision-making.

The relationship between childhood maltreatment and cluster B personality disorders: a systematic review

Josephine Caesarlia, Monica Oktaviana, Steven Yulius Usman — Thu, 29 Jan 2026 00:00:00 +0700

Childhood maltreatment (CM) is known as a significant risk factor in the development of cluster B personality disorder (PD), which can lead to significant distress and functional impairment. This systematic review aimed to evaluate the relationship between childhood maltreatment and cluster B PDs. We obtained studies from Google Scholar, PubMed Central, SpringerLink, EBSCOHost, and ScienceDirect from 2015 to July 2024 using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) 2020 as the guideline. The Medical Subject Headings (MeSH) terms of "childhood maltreatment," "personality disorders," "cluster B personality," "borderline," "antisocial," "histrionic," and "narcissistic" were used for conducting a systematic search. The included studies concentrated on individuals with cluster B PDs who had experienced maltreatment as children (CM). The risk of bias was assessed using the New Ottawa Scale. The PROSPERO registration number for this systematic review is CRD42024607386, which included 18 studies that were conducted in various countries. The studies included 11 cross-sectional, 1 case-control, 3 cohort, and 3 longitudinal designs, with sample sizes ranging from 78 to 36,309 participants. The results showed a strong association between CM and cluster B PDs development. Abuse and neglect experiences were correlated with an increased risk of developing PDs such as narcissistic, borderline, antisocial, and histrionic types. In this systematic review, CM was strongly associated with the development of Cluster B PDs.

Assessment effect on integrative supportive care in improving quality of life of breast cancer survivors: meta-analysis of randomized controlled trials

Wahyu Tri Sudaryanto, Ika Yuli Ayuningrum — Thu, 29 Jan 2026 00:00:00 +0700

There is growing international recognition of the essential role of support for cancer patients’ well-being. Supportive care is an expected modality to manage side-effects of treatment, to maintain physical and psychological well-being, and to improve survivorship since the initial cancer diagnosis. The purpose of this study was to synthesize the evidence and assess the effect of integrative supportive care on quality of life (QoL) in breast cancer patients. A systematic review and meta-analysis on QoL in cancer patients was carried out under the guidance of PRISMA. Eligible studies were identified through a systematic literature search of PubMed and ScienceDirect databases using MeSH terms.Full text of randomized controlled trials comparing psychologically related supportive care vs. usual care in adult (≥18 years old) cancer patients, published from 2013 to 2023 were included. 10 RCTs reported that supportive care has been implemented in developed countries and 3 studies were conducted in developing countries. Supportive care had a higher impact on QoL in cancer patients than the standard care (SMD= 0.24; 95% CI= 0.08 to 0.40), with p<0.001. This study had high heterogeneity (I²= 74%). Integrative supportive care is increasingly being adopted in developed countries and has been shown to positively impact the QoL among cancer survivors.