Health Checks Research Articles

Health Catch-UP!: a realist evaluation of an innovative multi-disease screening and vaccination tool in UK primary care for at-risk migrant patients

BackgroundMigrants to the UK face disproportionate risk of infections, non-communicable diseases, and under-immunisation compounded by healthcare access barriers. Current UK migrant screening strategies are unstandardised with poor implementation and low uptake. Health Catch-UP! is a collaboratively produced digital clinical decision support system that applies current guidelines (UKHSA and NICE) to provide primary care professionals with individualised multi-disease screening (7 infectious diseases/blood-borne viruses, 3 chronic parasitic infections, 3 non-communicable disease or risk factors) and catch-up vaccination prompts for migrant patients.MethodsWe carried out a mixed-methods process evaluation of Health Catch-UP! in two urban primary healthcare practices to integrate Health Catch-UP! into the electronic health record system of primary care, using the Medical Research Council framework for complex intervention evaluation. We collected quantitative data (demographics, patients screened, disease detection and catch-up vaccination rates) and qualitative participant interviews to explore acceptability and feasibility.ResultsNinety-nine migrants were assessed by Health Catch-UP! across two sites (S1, S2). 96.0% (n = 97) had complete demographics coding with Asia 31.3% (n = 31) and Africa 25.2% (n = 25), the most common continents of birth (S1 n = 92 [48.9% female (n = 44); mean age 60.6 years (SD 14.26)]; and S2 n = 7 [85.7% male (n = 6); mean age 39.4 years (SD16.97)]. 61.6% (n = 61) of participants were eligible for screening for at least one condition and uptake of screening was high 86.9% (n = 53). Twelve new conditions were identified (12.1% of study population) including hepatitis C (n = 1), hypercholesteraemia (n = 6), pre-diabetes (n = 4), and diabetes (n = 1). Health Catch-UP! identified that 100% (n = 99) of patients had no immunisations recorded; however, subsequent catch-up vaccination uptake was poor (2.0%, n = 1). Qualitative data supported acceptability and feasibility of Health Catch-UP! from staff and patient perspectives, and recommended Health Catch-UP! integration into routine care (e.g. NHS health checks) with an implementation package including staff and patient support materials, standardised care pathways (screening and catch-up vaccination, laboratory, and management), and financial incentivisation.ConclusionsClinical Decision Support Systems like Health Catch-UP! can improve disease detection and implementation of screening guidance for migrant patients but require robust testing, resourcing, and an effective implementation package to support both patients and staff.

Linking health-related behaviours to quality of life in older adults: A latent class analysis

Abstract Background Life expectancy and healthy life years diverge considerably in Austria, and quality of life (QoL) varies widely among older people. Identifying the factors most relevant to QoL in older people is crucial. We aimed to investigate the association between health behaviour, including lifestyle and preventive behaviour, and QoL in this population. Methods Cross-sectional data from the Austrian Health Interview Survey (2019) were used, including 3,995 individuals aged 65 years and older. We performed latent class analysis (LCA) to identify patterns of health behaviours. Variables were selected based on the WHO framework of Active Ageing including factors related to lifestyle (physical exercise, fruit/vegetable intake, BMI, oral health, smoking, alcohol use) and the health care system (satisfaction, unmet needs, participation in screening, health checks and vaccination). Domain scores of the WHOQOL-BREF were used for QoL assessment. Class differences were assessed by survey regressions. Results In the LCA, four different behavioural classes emerged among the older-aged Austrian population, including (class 1) ‘best preventive behaviour and very good lifestyle’ (17.7%), (class 2) ‘worst lifestyle and worst preventive behaviour, high unmet healthcare needs and unsatisfied with the system’ (16.5%), (class 3) ‘very good preventive behaviour and best lifestyle, but worst vaccination probability’ (24.8%) and (class 4) ‘poor preventive behaviour, good lifestyle, but no physical activity’ (41.0%). The classes with unhealthy lifestyles (classes 2 and 4) had worse QoL in all domains compared to the classes with healthy lifestyles (classes 1 and 3). The four classes differ on demographic, socio-economic and health characteristics. Conclusions To improve the QoL of the older population, policies and interventions need to be tailored to the specific characteristics and needs of each behavioural class. Key messages • This study explores the relationship between health behaviour and QoL in older Austrians. • Findings support the development of differentiated interventions targeting different types of behaviour.

An integrated work health intervention among cleaners in Denmark

Abstract Introduction Work-related diseases are increasing and considered a global health challenge. Meanwhile, work-related risk factors and diseases are not equally distributed across occupational groups. Previous work health interventions have not succeeded in reducing the prevalence of work-related diseases. Therefore, integrated approaches combining prevention of disease and promotion of health in work health interventions have been developed. The aim of the Integrated Approach to Health, Wellbeing, and Productivity at Work (ITASPA) intervention was to prevent work-related injuries and diseases and promote the health, safety and wellbeing of cleaners. Methods The ITASPA intervention was implemented at two Danish workplaces among cleaners. At each workplace a committee of employees was established to develop their own initiatives to promote the health of the workers. By use of the British Medical research Council’s framework, a process evaluation was conducted. Qualitative data (focus group interview and field notes) and quantitative data (questionnaires) of participants evaluated the implementation. Results A total of 91 cleaners participated in health checks, and three workshops were held at each workplace. The development and implementation of activities was affected by mechanisms, such as lack of information about the intervention, new power dynamics, and lack of motivation for behavior changes, and contextual factors, such as many replacements, time pressure and absence of managers. Conclusions Integrated approaches in work health interventions among employees with short or no education may positively impact employees’ health, wellbeing and safety if comprehensively implemented. However, attention should be drawn to interventions that adapt a participatory design, as unintended power dynamics may occur when employees are given the tasks of implementing behavior changes among colleagues. The role of managers to obtain successful implementation should be highlighted.

The Longlasting Program Keluarga Harapan as Conditional Cash Transfer in Indonesia: The Existing Problems and the Policy Recommendations

Program Keluarga Harapan (PKH) is a conditional cash transfer program in Indonesia that requires beneficiaries to meet certain requirements such as school attendance and health checks. Adopted from similar models in Latin America, PKH aims to reduce short-term poverty and invest in the health and education of future generations. Since its launch in 2007, PKH has operated in various regions with different poverty and infrastructure issues. PKH faces several challenges, including mistargeting of beneficiaries and burdensome bureaucracy for the poor. To address this, improvements to the targeting system and simplification of document procedures are recommended. The program has also contributed to reducing stunting through improved nutrition and health education, although health facilities need to be improved. In the education sector, PKH has succeeded in increasing school enrollment and attendance, but has not significantly reduced child labor. In terms of livelihoods, PKH encourages beneficiaries to shift to non-agricultural jobs, although often only casual labor. This study uses descriptive and explanatory designs to describe and explain the evolution of the PKH policy from 2007. Descriptive design is used to describe policy changes that occurred during the period, while explanatory design is used to explain the factors that influence policy changes and their impact on program effectiveness. The results found that there were problems with PKH facilitators including insufficient numbers, high workloads, and low salaries, which affected their effectiveness. To improve the performance of facilitators, new recruitment, regular training, and increased salaries and working conditions are recommended.

Embedding a text message recall system to increase the uptake of cardiovascular screening in Australian general practice. Results of the Text to Detect randomised controlled trial

Abstract Background Australian guidelines recommend cardiovascular disease (CVD) risk screening for adults aged 45-74 years, but less than one in three have blood pressure and cholesterol recorded within their general practitioner (GP) records. Medicare subsidised ‘Heart Health Checks’ were introduced in primary care in 2019, however uptake has been suboptimal. Purpose The aims of this study were to; 1) implement a text mediated Heart Health Check recall program within general practice at scale, 2) determine whether uptake can be increased with nudge reminder text messages and 3) evaluate the impact on risk factor measurement and medication prescription. Methods Australian general practices were invited via advertisement and mailing list. Medical record software identified patients eligible for a Heart Health Check. Practices were randomised to one of three arms: 1) standard SMS: 1 SMS inviting patients to see their GP for a Heart Health Check, 2) nudge reminder: standard SMS + nudge reminder two weeks later, 3) control: no SMS. Aggregate, deidentified, practice-level data was extracted at baseline and 3-months. The primary outcome was the proportion of Heart Health Checks delivered at a practice level. Secondary outcomes included updated CVD risk factor assessment and new medication prescriptions. Analyses used ANOVA and Tukey's HSD. Results Between 2022 and 2023, 206 general practices participated, each with 560 median eligible patients (IQR:297-909). A total of 70,679 recall text messages and 34,406 nudge reminder messages were sent. Heart Health Check uptake was 11 and 16 times higher in the standard and nudge arms (respectively) compared to control (0.4 vs 4.5 vs 6.3 per 100 patients, p<0.001), with a 40% statistically significant increase (p=0.02) for 2 SMS vs 1 SMS. Updated cholesterol values were 31.6 and 60.2% higher in standard and nudge arms (respectively) compared to control (13.7 vs 16.8 vs 17.4 per 100 patients, p=0.02). Both active arms were statistically significantly different from control (standard p=0.047, nudge p=<0.001). Updated blood pressure was 23.0 and 26.8% higher in the standard and nudge arms (respectively) compared to control (13.7 vs 16.8 vs 17.4 per 100 participants), however only the nudge arm was statistically significantly different (p=0.38). New medication prescription (lipid or blood pressure-lowering) was 36.8% higher in the nudge arm compared to control (32.1 vs 43.9 patients per practice, p=0.03). Conclusions This study demonstrates the effectiveness of text mediated recall of eligible patients to increase the uptake of cardiovascular risk screening in Australian general practice. The findings will inform the implementation of new Australian guidelines and policy reform.

Understanding and addressing the needs of refugee and asylum-seeking children and young people

Abstract Issue/problem Europe is home to an increasing number of refugee and asylum-seeking children at risk of health and wellbeing needs due to their life experiences. They are frequently marginalised, impoverished, and face barriers accessing the healthcare and support they need. Bevan, an English social enterprise providing health and wellbeing services to Inclusion Health populations, carried out a needs assessment of migrant children registered at one of its General Practices to determine challenges and opportunities to ensuring their right to health. The knowledge and learning generated is relevant across sectors; organisations and geographical boundaries. Description of the problem The assessment included a literature review, audit of child new patient health checks, service mapping, multi-agency stakeholder interviews and a consultation event with unaccompanied minors. Findings informed Bevan’s Migrant Children and Young People (CYP) Strategy, local service development and system-wide recommendations. Results Key areas of concern identified included mental health; safeguarding; development; nutrition; and inter agency working. Challenges to meeting needs were complex and included national policies, poor provider understanding of rights and entitlements, language and cultural barriers, health service waiting lists, housing and silo-working. Lessons Responding to findings Bevan invested in an in-house CYP mental health service and CYP social prescriber, opened a drop-in clinic and wellbeing service for unaccompanied minors, and initiated orientation and health information sessions for new arrivals with peer advocate support. Bevan now hosts a city-wide cross-sector Migrant CYP stakeholder group and collaborates with regional and national partners to develop resources to promote the health of migrant CYP. Key messages • The needs assessment enabled development of a responsive integrated service for migrant CYP that meets their health needs and addresses their social determinants of health. • The Migrant CYP stakeholder group has improved inter-agency working, helped identify service gaps, increased advocacy opportunities, and facilitated co-creation of solutions to meet population needs.

Self-Guided Blood Pressure Screening in the Community, Opportunities, and Challenges.

Community-based health check kiosks provide opportunities to improve the detection and long-term monitoring of hypertension. We describe the sociodemographic and cardiovascular characteristics of first-time and repeat users of these kiosks. This was an observational study. Deidentified data collected from 430 SiSU Health consumer-facing health check stations in pharmacies across Australia between January 2018 and November 2020 were analyzed. Using a logistic regression, we identified factors associated with repeat checks in the overall cohort and in those with possible hypertension presented as adjusted odds ratios (aOR) and 95% CIs. A total of 982 122 unique checks were conducted; 54% (n=530 139) of the health check users were female, and the average age of all users was 38.2 (SD, 16.0) years. Notably, 13% used the kiosks more than once. Overall, 22% met the definition of possible hypertension, 16% (n=136 345) had blood pressure (BP) ≥140/90 mm Hg, 4% (n=34 349) had BP >160/100 mm Hg, and 13% (121 282) reported taking BP medicines. In the adjusted analysis, first-time users who were aged 50 to 69 years (aOR, 0.91 [95% CI, 0.87-0.96]) or ≥70 years (aOR, 0.68 [95% CI, 0.62-0.74]) were less likely than young users (18-29 years) to return for a second health check. Those in very remote areas were 61% (aOR, 0.39 [95% CI, 0.19-0.72]), and smokers were 13% less likely to return (aOR, 0.87 [95% CI, 0.83-0.91]). People taking BP medications were more likely to return (aOR, 1.16 [95% CI, 1.09-1.22]). Community-based health checks may identify people with high BP and could provide an option for self-monitoring. Broader implementation is needed to increase the reach in rural areas and among the elderly population.

Edukasi Pemanfaatan Minyak Jelantah Dan Daun Kelor Menjadi Sabun Batang Sebagai Upaya Pencegahan Paparan Logam Berat Dari Pewarna Sintetis Dan Pestisida di Desa Tlingsing, Cawas, Klaten

Oxidative stress induced in cells by the generation of reactive oxygen species (ROS) is a toxic effect of heavy metals that exceed the threshold if they enter the body and can cause health threats. Apart from heavy metals that can cause oxidative stress are pesticides. The impact of oxidative stress will disrupt health because it has damaging properties on proteins, DNA and lipids. Exposure to heavy metals by workers and pesticides by farmers through skin contact, inhalation or respiration, to reduce the impact of inhalation or contact on the skin, in this service workers and farmers are given PHBS education, and one of them is by maintaining cleanliness after contact with colors or pesticides by means of wash your hands using soap. Community service is provided through counseling methods, health checks in the form of MCU, and making Moringa leaf soap which contains antioxidants

Health dialogue intervention versus opportunistic screening in primary care for type 2 diabetes and cardiovascular disease prevention in settings with low socioeconomic status (DETECT): study protocol for a pragmatic cluster-randomized trial

BackgroundMeta-analyses of randomized trials suggest that health checks and health promotion interventions targeting behavior change in primary care do not prevent cardiovascular morbidity and mortality in the general population. However, whether such interventions are more effective in high-risk populations, such as people living in low socioeconomic settings, remains unclear, as they have been poorly represented in previous trials. Therefore, we aim to evaluate the effectiveness, cost-effectiveness, and implementation of systematic screening followed by an individually oriented, lifestyle-focused, health dialogue intervention for prevention of type 2 diabetes and cardiovascular disease, as compared to opportunistic screening, in primary care in socioeconomically disadvantaged areas.MethodsUsing an overall pragmatic approach and a cluster-randomized design with two arms, we aim to enroll 3000 participants aged 50–59 years from 30 primary care centers (PCCs) with an above-average level of Care Need Index in Stockholm Region, Sweden. PCCs will be randomized (1:1) either to a health dialogue intervention, which includes inviting enlisted patients to a systematic screening of risk factors followed by an individually oriented lifestyle-focused health dialogue, or to opportunistic screening, which includes screening patients for a smaller set of risk factors during an appointment at their PCC taking place for other reasons. The main outcome will be change in systolic blood pressure during 6- and 12-month follow-ups. Additional short-term outcomes will be changes in other biological risk factors, health-related quality-of-life, and lifestyle habits, as well as process and implementation outcomes, and unintended side effects. The long-term effect on type 2 diabetes and cardiovascular disease incidence and mortality will be examined using regional and nationwide registers. Changes in systolic blood pressure and other health outcomes will be analyzed using mixed-effect generalized linear modeling and mixed-effect Cox regression to capture variability between and within PCCs. A health economic evaluation will assess resource use and costs in the short- and long-term.DiscussionThis trial of lifestyle-focused health dialogues and opportunistic screening in primary care in socioeconomically disadvantaged areas in the largest region of Sweden has the potential to yield valuable insights that could support evidence-based policymaking.Trial registrationClinicalTrials.gov (NCT06067178). Prospectively registered September 27, 2023.

Estimating and Predicting the Rate of Kidney Function Decline over 10 years in the General Population.

We aimed to estimate the rate of kidney function decline over 10 years in the general population and develop a machine learning model to predict it. We used the JMDC database from 2012 to 2021, which includes company employees and their family members in Japan, where annual health checks are mandated for people aged 40-74 years. We estimated the slope (average change) of estimated glomerular filtration rate (eGFR) over a period of 10 years. Then, using the annual health-check results and prescription claims for the first five years from 2012 to 2016 as predictor variables, we developed an XGBoost model, evaluated its prediction performance with the root mean squared error (RMSE), R2, and area under the receiver operating characteristic curve (AUROC) for rapid decliners (defined as the slope <-3 ml/min/1.73 m2/year) using 5-fold cross validation, and compared these indicators with those of (i) the simple application of the eGFR slope from 2012 to 2016 and (ii) the adjusted linear regression model. We included 126,424 individuals (mean age, 45.2 years; male, 82.4%; mean eGFR, 79.0 ml/min/1.73 m2 in 2016). The mean slope was -0.89 (standard deviation, 0.96) ml/min/1.73 m2/year. The predictive performance of the XGBoost model (RMSE, 0.78; R2, 0.35; and AUROC, 0.89) was better than that of either the simple application of the eGFR slope from 2012 to 2016 (RMSE, 1.94; R2, -3.03; and AUROC, 0.79) or the adjusted linear regression model (RMSE, 0.81; R2, 0.30; and AUROC, 0.87). We estimated the rate of kidney function decline over 10 years in the general population as well as demonstrated that application of machine learning to annual health-check and claims data provides better predictive performance compared to traditional methods.

A-002 Analytical Validation of the Zybio High Sensitivity Cardiac Troponin I CLIA Assay

Abstract Background High-sensitivity cardiac troponin (hs-cTn) plays a pivotal role in the early diagnosis of Acute Coronary Syndrome (ACS). With technological advancements, the sensitivity of troponin assays has significantly improved. The International Federation of Clinical Chemistry (IFCC) criteria for hs-cTn assays include a total imprecision (Coefficient of Variation, CV) ≤10% at the gender-specific 99th percentile value and detectable levels in ≥50% of a healthy population. This study aims to evaluate the performance of Zybio's hs-cTnI assay against these high-sensitivity standards Methods This study involved 1661 individuals undergoing routine health checks at Chongqing Medical University Third Hospital. Exclusion criteria included recent medication use, abnormal NT-proBNP levels, significant cardiac silhouette changes in chest X-rays, age &amp;lt;20, incomplete data, pregnancy, or history of severe chronic diseases. Participants were classified into apparent healthy and healthy groups based on blood pressure, lipid profiles, and electrocardiogram results. Laboratory examinations included hs-cTn and NT-ProBNP concentrations using Zybio's chemiluminescence instrument EXI2400 and associated reagent kits, with other parameters measured using standard biochemical and high-performance liquid chromatography methods. Results Of the 1247 participants (556 males, 691 females) included in the final analysis, 1157 showed detectable hs-cTnI levels above the limit of detection (LOD), yielding an overall detection rate of 92.78%. Detection rates were 93.71% in males and 92.04% in females. The total imprecision (CV) of hs-cTnI at gender-specific 99th percentile values over 20 days was below 10%, meeting the high-sensitivity criteria. This finding was consistent across lower and higher concentration ranges. Conclusions The Zybio hs-cTnI assay demonstrated a high detection rate in a healthy population, with 92.78% detectability overall, 93.71% in males, and 92.04% in females. The assay met the high-sensitivity criteria of IFCC, with a total imprecision (CV) of less than 10% at the gender-specific 99th percentile levels. These results validate the utility of Zybio's hs-cTnI assay for clinical application in the early diagnosis of ACS.

Revolutionizing Workplace Safety Through Innovative Ergonomic Solutions in Indonesia

General Background: Workplace accidents significantly impact employee health, productivity, and organizational efficiency, necessitating effective safety and health management strategies. Specific Background: The study investigates the use of the Macro Ergonomic Analysis and Design (MEAD) method at PT Esprobags to improve occupational health and safety measures. Knowledge Gap: PT Esprobags faces challenges in effectively addressing employee health concerns, especially regarding health insurance and workplace conditions, despite increasing demand for safety protocols. Aims: This research aims to identify key health and safety issues affecting employees, utilizing MEAD to analyze and design solutions that mitigate workplace accidents and improve overall employee well-being. Results: The findings indicate that inadequate health insurance and infrequent health checks, along with insufficient drinking water quality and room cleanliness, are primary concerns among employees. The analysis reveals that environmental factors significantly influence employee safety, health, and performance, contributing to a 60.7% variance in the work environment's impact on safety and performance. Novelty: This study introduces a structured ergonomic approach tailored to the unique needs of the manufacturing sector, emphasizing the importance of holistic workplace assessments. Implications: PT Esprobags' implementation of the MEAD methodology can improve employee satisfaction, productivity, and safety, contributing to a broader understanding of workplace ergonomics and occupational health. Highlights: Health Concerns: Inadequate health insurance and checks impact employee well-being. Environmental Impact: Workplace conditions significantly affect safety and productivity. Implementation Benefits: MEAD enhances satisfaction and reduces workplace accidents. Keywords: workplace safety, ergonomic analysis, employee health, Macro Ergonomic Analysis and Design, occupational safety

Development and implementation of a digital remote symptom monitoring program (RESPONSe) to support patients undergoing IV chemotherapy at a community ambulatory cancer clinic in Richmond, BC, Canada.

406 Background: We identified delays in accessing symptom management during treatment as an existing care gap at the Richmond Cancer Clinic. Patient-reported outcome measures (PROMs) have been demonstrated to communication, quality of life, and reduce symptom burden and acute care utilization. The RESPONSe program was initiated to address this gap by implementing a digital remote symptom monitoring (RSM) system paired with a supporting Symptom Management Nurse (SMN). Methods: We designed a digital RSM system to collect PROMs at specific timepoints during the first 6 months of IV chemotherapy initiation, with automated triaging logic to flag symptoms of concern that would result in a phone call from the SMN. Routine surveys include baseline, health-checks on days 3 and 10 post-chemotherapy, and pre-doctor’s-appointment; with optional health checks available anytime. Through competitive procurement, SeamlessMD was selected as the technology partner. From Aug 2023 to Jan 2024, multiple design cycles with dry run testing were held to incorporate branching logic, COSTARS oncology symptom specific questionnaires, automatic triaging flags, immediate self—management tips and links to educational resources. Concurrent development of SMN clinical workflows included in-person patient enrolment, digital dashboard monitoring and integration with the clinical chart. Results: From Jan 22-Apr 30, 2024, 32 patients have been enrolled with 42% over the age of 70. 90% of patients completed the baseline survey, 79% of patients completed at least 1 post-treatment health check and 45% completed at least 1 pre-doctors’-appointment survey. An average of 22 library resources were accessed per patient. Through the system, 19 severe and 34 moderate symptoms were identified. The dashboard prompted 63 telephone calls from the SMN, with a further 28 follow-up calls required. Early 3-month patient experience surveys (n=8) indicate high satisfaction, with 100% of patients saying they would recommend the program to others undergoing treatment. 87.5% of patients felt the system was very helpful in communicating their issues to the clinical team, with 100% reporting very high/extreme satisfaction with the support provided by the SMN. Additionally, 67% of patients felt very satisfied with the RESPONSe program overall. Conclusions: The RESPONSe program demonstrates the potential of digital RSM systems in improving patient-centered care and assisting with symptom reporting and management. Initial results suggest high engagement and patient satisfaction, showing this is a feasible approach in community oncology settings. We will be reviewing acute care utilization to assess the impact of the RESPONSe program on emergency room visits and hospitalization.

Spontaneous Clearance of Chlamydia trachomatis and Its Associated Factors among Women Attending Screening for Chlamydia in Shenzhen, China.

ObjectivesThis study aimed to investigate the factors associated with the spontaneous clearance of Chlamydia trachomatis, a phenomenon that, despite a growing body of literature, remains understudied in the context of women in China. MethodsSpontaneous clearance was defined as the transition from a positive to negative Chlamydia status over time without the use of antichlamydial therapy. Data from 5,935 women aged 18 years and older who participated in the Clinical-Based Health Check program were analyzed. Eligible participants had no history of Neisseria gonorrhoeae infection, pelvic inflammatory disease, recent antibiotic use, or pregnancy and had an interval between the screening and follow-up visits of more than three days. Logistic regression was used to identify factors influencing spontaneous clearance. ResultsSpontaneous clearance occurred in 23.9% (50/209) of the participants, typically with a median interval of 27 days. Significant factors included an interval > 45 days, an age > 35 years, the use of an intrauterine device (IUD), and the presence of clue cells. ConclusionSpontaneous clearance of C. trachomatis is significantly affected by age, the interval between two tests, IUD use, and the presence of clue cells. Screening strategies should prioritize women under 35 years of age who do not use IUDs and test negative for clue cells for more effective chlamydia prevention and management.

An integrated approach combining experimental, informatics and energetic methods for solid form derisking of PF-06282999

The landscapes of observed and predicted three-dimensional crystal packing arrangements of small-molecule drug candidates can be complex. The possible appearance of a more thermodynamically stable solid form during drug development has led to the digital workflow of informatics-based risk assessments, named a Solid Form Health Check. Herein, we describe the use of a combined approach consisting of experiments, informatics together with energetic calculations in analysis of four competing polymorphs of PF-06282999, a myeloperoxidase (MPO) inhibitor with conformational flexibility and multiple plausible hydrogen bond networks. This combined approach offered a comprehensive understanding of the solid form structure, properties, and performance, ensuring robust solid form derisking and selection.

P2.04A.04 The Lung Health Check Pilot: Ireland's Flagship Lung Cancer Screening Trial

P2.04A.04 The Lung Health Check Pilot: Ireland's Flagship Lung Cancer Screening Trial

Peningkatan Pola Asuh Melalui Penyuluhan Gizi dan Kesehatan di Kelurahan Samaan, Kota Malang

Nutrition and health counseling in Samaan Village, Malang City, aims to increase parents' understanding of the importance of proper parenting in supporting child development, especially in the context of stunting prevention. Through a Participatory Action Research (PAR) approach, this activity involved posyandu cadres and the PKK mobilizing team in designing and implementing counseling. The materials presented focused on balanced nutrition, psychological stimulation, and the importance of routine health checks for toddlers. The results of the counseling showed an increase in parents' understanding of the importance of nutrition in supporting children's physical and cognitive development, as well as the application of better parenting.

Healthy Warrior Effect With Deployment to United Nations Peacekeeping Operation: A Longitudinal Study Among Japan Ground Self-Defense Forces.

The "healthy warrior effect" (HWE), in which deployed military personnel are healthier than those not deployed, is known to be associated with deployment. However, the HWE associated with deployment to United Nations (UN) peacekeeping operations (PKO) has not been examined. This study examined the HWE associated with deployment to UN PKO by examining the impact of pre-deployment mental health on the likelihood of deployment and whether this difference persisted after deployment. This retrospective cohort study included 2,712 Japan Ground Self-Defense Forces personnel from four engineering units who consented to participate in annual mental health checks conducted between August and October 2015. The Kessler Psychological Distress Scale (K6) was used to assess general psychological distress before and after deployment. Logistic regression analysis adjusted for age, sex, and rank was conducted with deployment as the dependent variable and the pre-deployment K6 total score as the independent variable. Additionally, a mixed-effects model was performed with K6 total scores as the dependent variable, time and deployment as fixed effect factors, and the individual as the random effect factor. Of the participants, 254 were in the deployed group, and 2,458 were in the non-deployed group. The pre-deployment K6 total score was significantly lower (t = 5.2, P < .001) for the deployed group (0.67 ± 1.60) than for the non-deployed group (1.26 ± 2.41). Logistic regression analysis showed an odds ratio for the K6 total score before deployment as 0.87 (95% CI = 0.79-0.94). The mixed-effects model exhibited a significant negative main effect of being deployed (t = -5.1, P < .001) and a significant interaction effect between time and being deployed (t = -2.5, P = .012). Psychologically healthier personnel were more likely to be deployed for UN PKO and their better mental health status persisted after deployment, reflecting the HWE. However, personnel in good health may develop new mental health issues after their deployment, and more attention to health management will be essential before and after deployment.

RISK BEHAVIOR, HEALTH PROMOTION, AND HYPERTENSION IN PRODUCTIVE COMMUNITIES IN THE UPTD TAPOS DEPOK AREA

In 2021 at the Tapos Health Center, out of 9,352 hypertensive patients aged ≥ 15 years, only 1,547 people (16.5%) received standard services. This problem is a serious health challenge because hypertension contributes to the high mortality rate in the region. The purpose of this study is to identify the problem and its causes and provide alternatives to the existing problem. The research design used for this study is descriptive analytical. This research aims to identify problems and their causes and provide alternatives to existing problems. Data collection and observation were carried out offline and then the data was processed using the Matrix Criteria Method. The results obtained for the problem that is the top priority is the low public interest in health promotion. Therefore, alternative problem solving is needed that can increase public interest in participating in health promotion. As a solution, planning sustainable health programs related to hypertension is a top priority to increase public awareness and participation in hypertension prevention. The program includes periodic health checks, counseling, and joint sports activities. It is hoped that through this program, it can overcome the low public interest in health promotion and ultimately help reduce the risk of hypertension and improve overall public health.

Feasibility of multiorgan risk prediction with routinely collected diagnostics: a prospective cohort study in the UK Biobank

ObjectivesDespite rising rates of multimorbidity, existing risk assessment tools are mostly limited to a single outcome of interest. This study tests the feasibility of producing multiple disease risk estimates with...