cover
Article Per Year (5 Year)
All
Home Page
OAI Link
Editorial Team
Contact
Reviewer
Google Scholar
Contact Name
Firman Pardosi
Contact Email
par­do­si­.­fp­@­gmail.com
Phone
+6285261­42­3­8­65
Journal Mail Official
par­do­si­.­fp­@­gmail.com
Editorial Address
Universitas Sebelas Maret, Jl. Ir. Suta­mi­ 36A, Su­rakarta 57126, Central Java
Location
Kota surakarta,
Jawa tengah
INDONESIA
Journal of Epidemiology and Public Health
Published by Universitas Sebelas Maret
ISSN : 25490273     EISSN : 25490273     DOI : -
Core Subject : Health,
Public Health
Background: Increased blood pressure for a long time can increase the risk of kidney failure, co­ronary heart disease, brain damage, and other di­seases. In 2019, it is estimated that hyper­tens­ion is experienced by 1.13 billion people in the world with most (two thirds) living in low and mid­­dle income countries. Other study also shows that the police and military are at risk of develop­ing hypertension due to a number of factors such as low know­led­ge about healthy and nutritious food, co-workers who are smokers, and consum­ing alco­hol. This study aimed to analyze the risk factors for hypertension in the police and military in the world using meta analysis. Subjects and Method: This was a meta-ana­lysis and systematic review. The articles used we­re obtained from Google Scholar, Springer Link, Pro­­Quest, and Science Direct databases. Selected arti­cles published from 2000 to 2020. Keywords to search for articles are as follows: hypertension po­lice personnel and military, or hypertension po­lice personnel and military. The articles studi­ed are 3 full text articles with cross sectional stu­dy designs and 1 full text articles with case cont­rol study design. Articles are col­lect­ed using PRI­S­­­MA diagrams, and analy­zed us­ing the Re­vi­ew Ma­nager application 5.3. Results: Overweight (aOR= 1.42; 95% CI = 1.01 to 2.00; p= 0.04), alcohol consumption (aOR­=­ 1.­55; 95% CI= 1.12 to 2.12; p= 0.007), ciga­rette con­­­­sumption (aOR= 1.45 ; 95% CI= 1.06 to 1.97; p= 0.020) is a risk factor for hyper­­­tension in the po­­­lice and military. Conclusion: Overweight, alcohol consump­tion, and cigarette consump­tion, are risk fac­tors for hypertension in po­lice and military personnel.
Arjuna Subject : -
Articles 659 Documents
 21   22   23   24   25 
Knowledge of Cervical Cancer Screening in Adult Women: Meta-Analysis Pradnyantara, I Gusti Agung Ngurah Putra; Chrisnanda, Indah Adhitama
Journal of Epidemiology and Public Health Vol. 7 No. 1 (2022)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (31.155 KB) | DOI: 10.26911/jepublichealth.2022.07.01.03

Abstract

Background: Cervical cancer is the fourth common cancer worldwide and the second most common cancer cases in women. Cervical cancer screening allows detection of abnormal cervical cells. Having knowledge about cervical cancer and its screening can increase the absorption of services for cervical cancer screening. This study was aimed to determine the comparison of participation in cervical cancer screening in adult women with high education with adult women with low education. Subjects and Method: This study was a systematic review and meta-analysis with the following PICO, population: adult women. Intervention: high knowledge. Comparison: low knowledge. Results: cervical cancer screening. The articles used in this study were obtained from two databases, namely Google Scholar and Pubmed. Keywords to search for "Knowledge," "screening" "cervical cancer" "adult women". The articles included are full-text articles with a cross-sectional study design from 2016 to 2022 and report multivariate analysis with Adjusted Odds Ratio (aOR). Articles were analyzed using the Review Manager 5.3 application. Results: Systematic study and meta-analysis of this study A total of 16 articles from 2 African continents (Ethiopia, Nigeria, Southern Ethiopia, South west Ethiopia, Ivory Coast, South Africa, Northwest Ethiopia, Cameroon, eastern Ethiopia, Ghana), and Asia (Thailand and Malaysia). Showed that women with high knowledge had an attitude to cervical cancer screening 3.63 times compared to women with low knowledge and the results were statistically significant (aOR = 3.63; 95% CI = 2.11 to 6.24; p<0.001). Conclusion: A high level of knowledge increases attitudes to cervical cancer screening in adult women. Keywords: screening, cervical cancer, knowledge. Correspondence: I Gusti Agung Ngurah Putra Pradnyantara, Poltekkes Permata Indonesia. Jl. Ringroad Utara No 22 C, Gandok, Condong Catur, Depok, Sleman, Yogyakarta, Indonesia. Email: gustipradnyantara1997@gmail.com. Mobile: +6282146804776.
Meta-Analysis: The Effect of Vaccination on the COVID-19 Infection
Journal of Epidemiology and Public Health Vol 8, No 1 (2023)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (31.184 KB)

Abstract

Background: The Indonesian government has determined that COVID-19 is a public health emer-gency and a non-natural national disaster that requires multi-strategy management. Strategies such as implementing health protocols and vaccination efforts to break the chain of transmission of COVID-19 must continue to be carried out massively. This study aims to analyze the effect of vaccina-tion on COVID-19 infection.Subjects and Method: This study is a systematic review and meta-analysis, with PICO as follows Population= population aged ≥18 years. Intervention= Vaccination. Comparison= Not vaccinated. Outcome= COVID-19 infection. The articles used in this study were obtained from several databases including PubMed, Google Scholar, and Scopus. These articles were collected over 2 months. The keywords to search for articles are as follows “Vaccine OR Vaccination AND (Infection OR Trans-mission) AND COVID-19 OR SARS-CoV-2”. The articles included in this study were full-text articles with a retrospective or prospective cohort study design. Articles are collected using PRISMA flow dia-grams. Articles were analyzed using the Review Manager 5.3 application.Results: A total of 10 articles reviewed in this meta-analysis study originating from England, Spain, France showed that COVID-19 vaccination is effective in reducing the risk of COVID-19 infection. People who were given the COVID-19 vaccine had a 0.22 times risk of being infected compared to those who were not vaccinated, and the reduced risk was statistically significant (aHR= 0.22; 95% CI= 0.13 to 0.36; p <0.001).Conclusion: COVID-19 vaccination is effective in reducing the risk of COVID-19 infection.Keywords: vaccination, infection, COVID-19, SARS-COV-2Correspondence: Farida Nurhayati. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: faridafay19@gmail.com. Mobile: +6285642154353.Journal of Epidemiology and Public Health (2022), 08(01): 35-44https://doi.org/10.26911/jepublichealth.2023.08.01.04. 
The Association of Epidemiological and Clinical Parameters with Diabetes and Hypertension in a Rural Area: A Mahbubnagar District Study Mavatkar, Munnaji Vyankatesh; Kanaparthi, Kiran Prakash; Sadamalla, Aruna Devi; Syed, Arif Mahboob; Vaia, Yamini Anjaneya Rao
Journal of Epidemiology and Public Health Vol. 7 No. 3 (2022)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (32.219 KB) | DOI: 10.26911/jepublichealth.2022.07.03.02

Abstract

Background: Rapid development in a country like India has also brought an explosion in the prevalence of non-communicable disease. Affluence to western culture can be one of the reason. This might have encroached the rural India. A cross‑sectional survey was done to assess the socio-demographic, clinical and laboratory factors diabetes and hypertension among the study population.Subjects dan Method: This is a descriptive cross-sectional study. A sample of 244 diabetes and hypertensive patients registered under the subcentre were taken as study subjects. Sociodemographic factor, clinical parameters and Laboratory parameters were taken independent variables. The dependent variables were diabetes and hypertension. Data analysis was done with help of SPSS version 26 software. Standard instruments were used to measure, weight, height, and waist circumference (WC), blood pressure. The random blood sugar, HbA1C and lipid profile values were taken from laboratory reports. The other variables were collected by questionnaire.Results: A total of 244 participants reported and responded to this study who were having diabetes, hypertension or both. About 35% of the population belonged to lower SEC. Amongst males almost 50% of the male had dual co-morbidity i.e Diabetes and Hypertension. About 85% of the population was Illiterate (p<0.05). Mean value of HbA1C was high among the diabetic patient who were under treatment (Mean= 7.10; SD=1.20). Lipid profile value were in normal range but higher compared to stats of other selected states.Conclusion: Study subjects even on treatment were unable to keep the laboratory parameters under control hence requiring indepth research. Keywords: Diabetes, hypertension, risk factors, Mahbubnagar District. Correspondence:Munnaji Vyankatesh Mavatkar. Assistant Professor Department of Community Medicine Government Medical College Mahbubnagar. Department of Community Medicine Government Medical College Mahbubnagar Yedira 509001. Email: Kiranmavatkar0647@gmail.com. Mobile phone: 08999712782.
Meta-Analysis the Effect of Asthma Comorbidity on the Mortality of COVID-19 Patients Munawaroh, Siti Mar'atul; Prasetya, Hanung; Murti, Bhisma
Journal of Epidemiology and Public Health Vol. 6 No. 2 (2021)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (30.72 KB)

Abstract

Background: COVID-19 is an infectious disease that spread throughout the world in December 2019. The risk factors for mortality of COVID-19 patients depend on comorbid diseases. Most of the comorbid diseases associated with COVID-19 deaths consist of hypertension, diabetes, obesity, cardiovascular disease, chronic obstructive pulmonary disease, chronic kidney disease, and asthma. This study aims to analyze the effect of comorbid asthma on mortality in COVID-19 patients.Subjects and Method: This research is a meta-analysis study using PRISMA flowchart guidelines. The article search process was carried out between 2020-2021 using databases from PubMed, Google Scholar, and Scopus. Based on the database, there were 15 articles that met the inclusion criteria. The analysis was carried out using the RevMan 5.3 software.Results: The 15 articles reviewed in the meta-analysis showed that comorbid asthma increased the mortality risk of COVID-19 patients and was statistically significant (aOR = 1.18; 95% CI = 1.02 to 1.36; p = 0.030).Conclusion: Asthma comorbidities increase the mortality of COVID-19 patients.Keywords: Asthma, mortality, COVID-19, SARS-CoV 2Correspondence:
The Effect of Obesity on the Severity of COVID-19: A Meta-Analysis Sari, Okky Nurlita; Murti, Bhisma; Sukamto, Ignatius Loyola
Journal of Epidemiology and Public Health Vol. 6 No. 4 (2021)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (31.157 KB)

Abstract

Background: Coronavirus Disease 2019 (COVID-19) is an infectious disease of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which first appeared at the end of 2019 in the city of Wuhan, China. Obesity is one of the comorbidities that increases the risk of COVID-19 severity. This study aims to estimate the magnitude of the effect of obesity on the risk of COVID-19 severity based on similar previous primary studies.Subjects and Method: This research is a systematic review and meta-analysis conducted by following the PRISMA flow diagram. The process of searching for articles through Google Scholar, PubMed and ScienceDirect journal databases by selecting articles published from 2020 to 2021. The keywords used include:
Meta Analysis: Relationship between Obesity and Dental Caries in Children Aprilia, Sholikha Dela; Kumalasari, Vilia Ayu; Utsani, Wimmy Safaati; Anasulfalah, Hakim
Journal of Epidemiology and Public Health Vol. 7 No. 2 (2022)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (31.736 KB) | DOI: 10.26911/jepublichealth.2022.07.02.05

Abstract

Background: Caries is an oral disease that often affects children around the world. The oral disease is related to several etiological factors with indicators of nutritional status, such as obesity and malnutrition. Studies linking overweight/obesity and caries experience in children have proved contradictory so far, the results including positive association, no association and inverse association. Therefore, this study aims to estimate the relationship between obesity and caries in children based on the results of several previous studies.Subjects and Method: This was a systematic study and meta-analysis. The search for articles was carried out by considering the eligibility criteria determined using the PICO model. The study population was children aged 6-15 years old with an intervention in the form of obesity, normoweight comparison and caries outcome. This article was collected for 3 weeks. The keywords to search for articles were as follows: “obesity” OR “overweight” AND “dental caries” AND “children”. The articles included in this study are full text articles with a cross sectional research design from 2012 to 2022. Articles were collected using the PRISMA flow chart. Articles were analyzed using the Review Manager 5.3 application.Results: A total of 9 articles contained in this study, including 3 articles from Brazil which is the continent of South America, 2 articles from Mexico which is the continent of North America, 1 article from Nigeria which is the African continent, 2 articles from China and 1 article from Arabia which is the continent of Asia. The results showed that obesity can reduce the incidence of dental caries in children by 0.82 times higher compared to children with normal weight (aOR = 0.82; 95% CI = 0.45 to 1.52; p = 0.540)Conclusion: Meta-analyses show that overweight and obese children have a lower risk of developing early childhood caries. Keywords: Obesity, Overweight, Caries Dental, Children Correspondence:Sholikha Dela Aprilia. Department of Nursing, Universitas Diponegoro. Jl. Prof. Sudarto No. 13, Tembalang, Semarang, Central Java, 50275. Email: ikadela23@gmail.com Mobile: 081390211993.
Link Between Obesity and The Severity of COVID-19 Infection: A Multicenter Retrospective Study in Dubai Hussein, Mawada Mohamed; Tahir, Amna; Tabash, Iman; Elhassan, Mona; Azaza, Nouha; Hassan, Ahd; Alsubbah, Hamzeh; Narainen, Meeruna; AlDabal, Laila
Journal of Epidemiology and Public Health Vol. 6 No. 3 (2021)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (33.612 KB)

Abstract

Background: Obesity is a major contributing factor for poor prognosis in many diseases and COVID-19 is no exception. Studies regarding the relationship between obesity and poor COVID-19 disease severity and outcome are however lacking in the gulf region. This study aimed to examine links between BMI and high mortality rate, duration of intensive care unit admission, and time on mechanical ventilation support among COVID-19 patients under the care of Dubai Health Authority (DHA) in the United Arab Emirates.Subjects dan Method: This was a retrospective, descriptive, record-based study of 637 patients admitted with confirmed SARS-CoV-2 PCR at three tertiary hospitals in Dubai, UAE. Demographic and clinical data were obtained from March 1st, 2020, through June 1st, 2020, all patients aged 18 and above were included, pregnant ladies were excluded. The dependent variables were ICU admission, COVID severity, need of respiratory support, viral clearance. The independent variables were the disease outcome between the obese and non-obese. The data were analyzed using chi-square test.Results: Total 200 (31.4%) were obese, while 435 (68.3%) were not obese. Most patients (81%) were male patients. Data Analysis reveals that obesity is associated with the risk of ICU admissions (OR=2.88, 95%CI=1.9 to 4.37; p<0.001). The findings also indicate that Covid-19 obese patients required higher respiratory support devices compared to non-obese patients (35.8% vs 16.3%, respectively) (OR= 2.87, 95%CI=1.93 to 4.27; p<0.001). Clinical severity at day 7th of hospital admissions among obese patients was direr compared to non-obese patients (34.5% vs 15.9%, respectively) (OR=2.79, 95%CI=1.87 to 4.16; p<0.001). Mortality rate at day 14 of admission were found higher among obese group too (9.5% vs 3.4%) (OR=2.95, 95%CI=1.46to 5.94; p= 0.020).Conclusion: This study indicates that COVID-19 patients with obesity (BMI more than 30 kg/m2) are found to have severer respiratory manifestations, higher mortality rate, prolonged periods of intensive care unit admission, and utilization of invasive mechanical ventilation.
Determinants of Duration of the First Birth Interval Using the Semi-parametric Survival Model in Uttar Pradesh, India: Evidence from NFHS – 5 (2019-2021)
Journal of Epidemiology and Public Health Vol 8, No 1 (2023)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (32.946 KB)

Abstract

Background: First birth is an important phenomenon in women life. It not only affects the duration of the rest of birth intervals but also affects the reproductive pattern of women. The study aims to explore the determinants of the duration of the first birth interval.Subjects dan Method: The cross-sectional study data of 33,275 women married between the years 2005-2021 aged (15-49) years from Uttar Pradesh, were selected from NFHS-5 data. The NFHS-5 sample is a stratified two-stage sample. Socio-demographic, socio-economic and cultural factors were taken as independent variables. The dependent variable was the first birth interval variable. Data analysis was performed on SPSS version 23 software and R Programming language for graphical representation. Cox proportional hazard models were applied for analysis.Results: The mean age of women at first marriage was 19.4; SD=3.26 years and the mean age of women at first birth was 21.39; SD=3.24 years. The median duration of the first birth interval was22 months with an IQR of 14 until 32 months. Cox hazard proportional analysis revealed that religion, residence, (ever) fetal loss, age at first birth, heard family planning, and women or husband education were found to be statistically significant factors associated with the duration of the first birth interval (p<0.001).Conclusion: There is a need to change the mindset of people towards the concept of the use of family planning methods to increase the length of the birth interval, regardless of various factors. This would help to increase the duration of the birth interval, improve the health of women and children, as well as help reduce population growth.Keywords: Uttar Pradesh, birth interval, semi-parametric, cox model, hazard plot.Correspondence: Jai Kishun, Department of Biostatistics and Health Informatics, Sanjay Gandhi Postgraduate Institute of Medical Sciences. Lucknow – 226014, India; email: jaikishan.stat@gmail.com. Mobile:Journal of Epidemiology and Public Health (2023), 08(01): 1-14https://doi.org/10.26911/jepublichealth.2023.08.01.01
Meta Analysis: The Effect of Age and Gender on Face Mask Use during COVID-19 Pandemic
Journal of Epidemiology and Public Health Vol 7, No 4 (2022)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (31.322 KB)

Abstract

Background: Coronavirus disease 2019 (COVID-19) is a world health problem in early 2020. The first case of COVID-19 was found in Wuhan China, the use of masks is intended to control the transmission of the virus to others and as a preventive measure, namely by providing protection to users who do not infected with viral exposure. The purpose of this study was to estimate the extent of adherence to wearing masks in the elderly and women through a meta-analysis of the primary study which was carried out by the previous authors.Subjects and Method: This study was a meta-analysis with the following PICO, PICO. Popula­tion: general population, intervention: age (older > 46) and gender (female), comparison: age (young 12 - 45 years) and gender (male), outcome: use of masks. The articles used in this study were obtained from three databases, namely Google Scholar, Pubmed, and Science Direct. With keywords such as: “mask and COVID-19 transmission”, “mask or COVID-19 transmission”. The articles included are full-text English with an observational study design from 2020 to 2022. Article selection was carried out using PRISMA flow diagram. Articles were analyzed using the Review Manager 5.3 application.Results: A total of 9 case studies from Europe, America and Asia were selected for systematic review and meta-analysis. The results showed that people over 46 years of age were 1.54 times more likely to use a mask than those under 45 years old (aOR= 1.54; 95% CI= 0.83 to 2.85; p= 0.170) and women were 1.12 times more likely to use a mask than men. -male (aOR= 1.12; 95% CI= 0.78 to 1.61; p= 0.550).Conclusion: Older age and women are more likely to wear masks.Keywords: wearing mask, gender, age, COVID-19Correspondence: Indah Adhitama Chrisnanda. Master Program in Public Health. Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java, Indonesia. Email: indahthama1919@gmail.com Mobile: 081216121662.Journal of Epidemiology and Public Health (2022), 07(04): 454-464https://doi.org/10.26911/jepublichealth.2022.07.04.04.
Meta-Analysis Effects of Diabetes Mellitus on Mortality in Patients with Chronic Heart Failure Paramita, Windya Kartika; Pratiwi, Yeocelin Mega
Journal of Epidemiology and Public Health Vol. 7 No. 1 (2022)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (30.92 KB) | DOI: 10.26911/jepublichealth.2022.07.01.08

Abstract

Background: Patients with diabetes mellitus have a higher risk of developing heart failure. Heart failure patients with diabetes mellitus will experience further health problems that are worse than heart failure patients without diabetes mellitus. This study was aimed to analyze the effect of diabetes on mortality in heart failure patients using a meta-analysis. Subjects and Method: This was a meta-analysis study using PRISMA flowchart guidelines. The PICO model used was Population= patients with chronic heart failure. Intervention= with diabetes mellitus. Comparison= not with diabetes mellitus. Outcome= mortality. The article search process was carried out between 2012 and 2021 using online databases from PubMed, Science Direct and Google Scholar. The keywords used in the article search were “Chronic Heart Failure” AND “Diabetes” AND “Mortality”. The inclusion criteria used in this study were full-text articles using a cohort study design, the research subjects were chronic heart failure patients, the study outcome was mortality, multivariate analysis with adjusted Hazard Ratio (aHR). The analysis was carried out using RevMan 5.3 software. Results: A total of 9 articles reviewed in the meta-analysis showed that diabetes mellitus increased the risk of mortality in patients with chronic heart failure 1.24 times compared with patients without diabetes mellitus (aHR= 1.24; 95%CI= 1.15 to 1.34; p< 0.001). Conclusion: Diabetes mellitus increases mortality in patients with chronic heart failure. Keywords: chronic heart failure, diabetes mellitus, mortality Correspondence: Yeocelin Mega Pratiwi. Faculty of Pharmacy, Universitas Gadjah Mada. Jl. Sekip Utara, Senolowo, Sinduadi, Sleman, Daerah Istimewa Yogyakarta 55281. Email: yeocelinmega@gmail.com. Mobile: +6282137652605.

Page 23 of 66 | Total Record : 659

 21   22   23   24   25 

Filter by Year

2016 2025


Reset
Filter By Issues
All Issue Vol. 10 No. 4 (2025) Vol. 10 No. 3 (2025) Vol. 10 No. 2 (2025) Vol. 10 No. 1 (2025) Vol. 9 No. 4 (2024) Vol. 9 No. 3 (2024) Vol. 9 No. 2 (2024) Vol. 9 No. 1 (2024) Vol. 8 No. 4 (2023) Vol. 8 No. 3 (2023) Vol. 8 No. 2 (2023) Vol 8, No 1 (2023) Vol. 8 No. 1 (2023) Vol 7, No 4 (2022) Vol. 7 No. 4 (2022) Vol 7, No 3 (2022) Vol. 7 No. 3 (2022) Vol. 7 No. 2 (2022) Vol. 7 No. 1 (2022) Vol. 6 No. 4 (2021) Vol. 6 No. 3 (2021) Vol. 6 No. 2 (2021) Vol. 6 No. 1 (2021) Vol. 5 No. 4 (2020) Vol. 5 No. 3 (2020) Vol. 5 No. 2 (2020) Vol. 5 No. 1 (2020) Vol 5, No 1 (2020) Vol 4, No 4 (2019) Vol 4, No 3 (2019) Vol 4, No 2 (2019) Vol 4, No 1 (2019) Vol 3, No 3 (2018) Vol 3, No 2 (2018) Vol 3, No 1 (2018) Vol 2, No 3 (2017) Vol 2, No 2 (2017) Vol 2, No 1 (2017) Vol 1, No 3 (2016) Vol 1, No 2 (2016) Vol 1, No 1 (2016) Vol. 1 No. 1 (2016) More Issue