To analyze the association between smoking status (active smoking and exposure to Second-Hand Smoking (SHS)) and the synergistic effect of smoking status and BMI with gout risk, a community-based case-control design was undertaken among 385 participants, including 304 healthy controls and 81 gout patients from seven community health services. Adjusted Odd Ratios (AORs) and 95% Confidence Interval (CIs) of gout for active smoking and SHS were 3.26 (95% CI = 1.07~9.90) and 4.67 (95% CI = 2.18~10.00) compared to non-smokers. Time-dependent manner of active smoking and SHS significantly increased gout risk with AORs and 95% CIs of 5.95 (1.41~25.03) and 10.12 (3.51~29.14). Dose-dependency of active smokers and SHS showed AORs and 95% CIs of 5.15 (1.28~20.63) and 4.37 (1.33~14.28). Smoking 20 cigarettes (one pack) per day for one year is equivalent to one pack-year. Active smoking >20 pack-year and SHS > 26.5 pack-year increased gout risk with AORs and 95% CIs of 7.18 (1.53~33.67) and 9.95 (3.64~27.22). Participants who smoked (active smoking and SHS) and with Body Mass Index (BMI) of > 24.9 kg/m2 synergistically increased gout risk, with an AOR of 9.65 and 95% CI of 3.25~28.65, compared to BMI ≤ 24.9 kg/m2 and non-smoker. Smoking status (active smoking and SHS) and the synergistic effect of smoking status and BMI increased gout risk in Indonesia.

Psychosocial Response and Strategy Coping of Stroke Patient in Ambon Cultural Context. Stroke is the dissolution of blood flow to the brain, due to the rupture of blood vessels or blockage of blood vessels to the brain. Stroke results in paralysis, sensory disorders, activity disorders, mental changes such as impaired thinking, awareness, concentration, impaired communication, and emotional disturbance. These changes require the ability of individuals to overcome these problems. This ability is known by the term strategy coping. In general, the known strategy of coping is problem-focused coping and emotion-focused coping. As part of the behavior, psychosocial responses and coping strategies influenced by culture. This study aims to describe the psychosocial response and coping strategy of stroke patients in the context of the culture in Ambon. The method in this study is a qualitative phenomenology approach. Data collection techniques used were in-depth interviews. The participants in this study were four people. Result obtained four themes: (1) physical changes, (2) independence in carrying out activities, (3) psychosocial responses, and (4) coping strategies in a cultural context. Physical changes experienced by participants due to stroke give rise to maladaptive and adaptive psychosocial responses. The coping strategies used to overcome the problem are emotional coping and focus coping issues that are influenced by Ambon culture.

Background: Most Indonesians with hyperuricemia are less than 40 years old, which suggests an increasing gout risk in the country. Meanwhile, untreated hyperuricemia was also suggested to lead to hypertension. Yet, it is unclear whether blood pressure (BP) plays a mediating role between urate and gout. Objective: We investigated the mediating effect of BP between urate and gout risk in Indonesians using a partial least squares-structural equation model. Method: A community-based retrospective case-control study was conducted between July 1 and August 31, 2019 in Indonesia. We randomly recruited 397 participants, including 86 patients with gout and 311 healthy controls from seven community health service centers. Multivariate logistic regression was employed to analyze the adjusted odds ratios of the association between risk factors, such as urate level and BP, and gout risk after controlling for other covariates. A path analysis was utilized to analyze the mediating effect of systolic BP between urate and gout. The STROBE reporting guideline for the observational study is adopted in our reporting. Result: We found that a 1 mg/dL increase of urate level significantly increased gout risk with an OR of 4.97 (95% CI: 3.48–7.09) and an AOR of 4.44 (95% CI: 3.07 –6.42) after adjusting for covariates. The association between urate and gout was also significantly mediated by systolic BP (β = 0.05; 95% CI Bias Corrected [0.02–0.08], p < 0.001). Conclusion: Urate was significantly associated with gout risk and was possibly mediated by increased systolic BP in Indonesians. Controlling systolic BP could be one of the strategies to decrease the risk of gout for individuals with hyperuricemia. Health education can be carried out by community health nurses to individuals on controlling their urate level and systolic BP to decrease the gout risk among Indonesian.

AbstrakPrediabetes adalah kondisi di mana kadar gula darah seseorang melebihi batas normalnamun belum terlalu tinggi untuk masuk dalam kategori penyakit diabetes mellitus, untukmencegah terjadinya diabetes mellitus bagi pasien pre-DM adalah dengan menerapkanperilaku pengendalian untuk mencegah penyakit diabetes mellitus. Tujuan penelitian iniuntuk mendeskripsikan perilaku pencegahan pasien pre-DM terhadap diabetes mellitusberdasarkan teori Health Belief Model di Puskesmas Sidorejo Lor Salatiga. Desain penelitianadalah kualitatif dengan pendekatan observasi dan wawancara menggunakan panduanwawancara terkait Health Belief Model dengan menghubungkan faktor persepsi kerentanan,keseriusan, manfaat, hambatan dan isyarat untuk bertindak. Populasi dalam penelitian iniyakni pasien pre-DM teregistrasi 1 tahun terakhir di Puskesmas Sidorejo Lor. Jumlahpartisipan sebanyak lima orang dengan kriteria GDP 100-125 mg/dl dan atau keluargamemiliki riwayat penyakit DM. Hasil perilaku pencegahan diabetes mellitus dari persepsikerentanan (keturunan penyakit kelurga), persepsi keseriusan (respon psikis), persepsihambatan (kesibukan pekerjaan), persepsi cues to action (diet gula, olahraga, konsumsi obatherbal dan medis), persepsi manfaat (perilaku yang dilakukan dalam pencegahan diabetesmellitus). Kesimpulan terdapat hambatan perilaku pencegahan terutama pada aktivitas fisikolahraga hal ini disebabkan kesibukan pekerjaan sehingga partisipan belum teratur dalammelakukan olahraga.Kata kunci: Diabetes Mellitus, Health Belief Model, Pre-DMAbstractPrediabetes is a condition in which a person&#39;s blood sugar level exceeds the normallimit but is not yet too high to be categorized as diabetes mellitus. To prevent diabetesmellitus for pre-DM patients is to apply control behavior to prevent diabetes mellitus. Thepurpose of this study was to describe the prevention behavior of pre-DM patients againstdiabetes mellitus based on the theory of the Health Belief Model at Puskesmas Sidorejo LorSalatiga. The research design was qualitative with an observation and interview approachusing an interview guide related to the Health Belief Model by linking perceived factors ofvulnerability, seriousness, benefits, barriers and cues to action. The population in this studywere pre-DM patients registered in the last 1 year at Sidorejo Lor Health Center. Thenumber of participants as many as five people with the criteria for GDP 100-125 mg / dl and/ or their families have a history of DM disease. The results of diabetes mellitus preventionbehavior from perceptions of vulnerability (family disease), perceptions of seriousness(psychological response), perceptions of barriers (busy work), perceptions of cues to action(sugar diet, exercise, consumption of herbal and medical drugs), perceived benefits(behaviors that are carried out in the prevention of diabetes mellitus). The conclusion is thatthere are barriers to preventive behavior, especially in physical activity, this is due to busywork so that the participants are not regular in exercising.Keywords: Diabetes Mellitus, Health Belief Model, Pre-DM

Objective: The prevalence of hypertension continus to increase. When suffering from hypertension, pattients must also carry out pressure management disease to control their blood. The Health Belief Model (HBM) can influence the pattient’s health behavior.The purpuseof this research is to analyze the relationship between the Health Belief Model and Manegement Hypertension in primary hypertension sufferes in Papua.Diabetes Mellitus, Methods: This article  use quantitative research with cross sectional design. The location of this research at Biak Kota Health Center, Papua from December 2019 until Ferbuary 2020. The criteria for respondents are hypertensive patients aged 20-55 years who were registered at the Biak Kota Health Center and the indigenous Biak Papua tribe. The instruments of research are the questionnaire Health Belief Model (about the level of confidence in the desease suffered) and hypertension management questionnaire (knowledge of the disease suffered and attitudes and actions taken). Patients also measured their blood pressure with a digital tension meter.Results:  of data analysis with correlation test is no relationship between all indicators in the health belief model and hypertension management.Conclusion: there is a relationship between the actions with serious of perception, benefits, behavior, and confidence in the health belief model with a weak correlation.