Health Research Data Research Articles

SOCIAL SUPPORT THROUGH FAMILY COPING MECHANISMS FOR CHILDREN WITH MENTAL RETARDATION IN SPECIAL NEEDS SCHOOL (SLB) BANDA ACEH

Mental retardation is a condition in which mental development is below average since birth or childhood, typically associated with overall lower intellectual development. The global prevalence of mental retardation in children is 14.8%. According to the 2018 Basic Health Research (Riskesdas) data, the prevalence of mental disorders and emotional disabilities in Indonesia was 9.8%, marking a 6% increase compared to 2013. The disability rate among children aged 5-17 in Indonesia is 3.3%, which includes cases of mental retardation. This study aims to explore the relationship between social support and coping mechanisms in families with mentally disabled children attending Special Needs Schools (Sekolah Luar Biasa) in the city of Banda Aceh in 2023. The research methodology is analytical, with a total population of 50 individuals. The sample consists of 50 parents of mentally disabled children selected through purposive sampling. The research was conducted from January 7th to 12th, 2023, and involved both univariate and bivariate analyses. The study's results indicate that out of 50 respondents, the most common type of social support is instrumental support, with 33 individuals (66%), and the majority of coping mechanisms fall into the adaptive category, with 35 individuals (70%). The p-value obtained is 0.004, suggesting a significant correlation between social support and coping mechanisms among parents of mentally disabled children. Hence, parents should keep learning about intellectual disabilities and become better at taking care of children with such challenges.

Towards a standardised cross-sectoral data access agreement template for research: a core set of principles for data access within trusted research environments.

Trusted Research Environments (TREs) are secure computing environments that provide access to data for approved researchers to use in studies that can save and improve lives. TREs rely on Data Access Agreements (DAAs) to bind researchers and their organisations to the terms and conditions of accessing the infrastructure and data use. However, DAAs can be overly lengthy, complex, and can contain outdated terms from historical data sharing agreements for physical exchange of data. This is often cited as a cause of significant delays to legal review and research projects starting. The aim was to develop a standardised DAA optimised for data science in TREs across the UK and framed around the 'Five Safes framework' for trustworthy data use. The DAA is underpinned by principles of data access in TREs, the development of which is described in this paper. The Pan-UK Data Governance Steering Group of the UK Health Data Research Alliance led the development of a core set of data access principles. This was informed by a benchmarking exercise of DAAs used by established TREs and consultation with public members and stakeholders. We have defined a core set of principles for TRE data access that can be mapped to a common set of DAA terms for UK-based TREs. Flexibility will be ensured by including terms specific to TREs or specific data/data owners in customisable annexes. Public views obtained through public involvement and engagement (PIE) activities are also reported. These principles provide the foundation for a standardised UK TRE DAA template, designed to support the growing ecosystem of TREs. By providing a familiar structure and terms, this template aims to build trust among data owners and the UK public and to provide clarity to researchers on their obligations to protect the data. Widespread adoption is intended to accelerate health data research by enabling faster approval of projects, ultimately enabling more timely and effective research.

Public attitudes towards genomic data sharing: results from a provincial online survey in Canada

BackgroundWhile genomic data sharing can facilitate important health research and discovery benefits, these must be balanced against potential privacy risks and harms to individuals. Understanding public attitudes and perspectives on data sharing is important given these potential risks and to inform genomic research and policy that aligns with public preferences and needs.MethodsA cross sectional online survey measured attitudes towards genomic data sharing among members of the general public in an Eastern Canadian province.ResultsResults showed a moderate comfort level with sharing genomic data, usually into restricted scientific databases with controlled access. Much lower comfort levels were observed for sharing data into open or publicly accessible databases. While respondents largely approved of sharing genomic data for health research permitted by a research ethics board, many general public members were concerned with who would have access to their data, with higher rates of approval for access from clinical or academic actors, but much more limited approval of access from commercial entities or governments. Prior knowledge about sequencing and about research ethics boards were both related to data sharing attitudes.ConclusionsWith evolving regulations and guidelines for genomics research and data sharing, it is important to consider the perspectives of participants most impacted by these changes. Participant information materials and informed consent documents must be explicit about the safeguards in place to protect genomic data and the policies governing the sharing of data. Increased public awareness of the role of research ethics boards and of the need for genomic data sharing more broadly is also needed.

DETERMINAN PRAKTIK MEROKOK KEPALA KELUARGA DI KELUHARAN CIBADUYUT KOTA BANDUNG

Smoking is a habit of smoking cigarettes carried out by society and is an unavoidable necessity for someone who has a tendency towards smoking. Based on 2018 Basic Health Research data, the prevalence of smoking in Bandung City exceeds the provincial figure, namely 34.04%. The lowest indicator of not smoking in the house in the city of Bandung is in Cibaduyut Village with a prevalence of 8.63%, so research was conducted on the behavioral determinants that influence the head of the family to practice smoking. The method used in this research is a quantitative method with a descriptive approach and the research design used is Cross Sectional. The research population of heads of families living in Cibaduyut sub-district was 2,716 heads of families. The sample of 249 heads of families was selected using a proportional random sampling technique, namely. The research instrument was a questionnaire and the data was analyzed by the chi square test at an alpha significance level of 0.05. The results of the research show that there were a relationship between the variables of attitudes include beliefs, values, traditions, affordability of cigarettes, and social environment with the smoking practices of family heads in Cibaduyut Village, Bandung City. Meanwhile, for the variables of knowledge and exposure to cigarette advertising, there was no significant relationship. Society is expected to start changing the paradigm that can influence smoking practices.

Data donation of individual shopping data to help predict the occurrence of disease: A pilot study linking individual loyalty card and health survey data to investigate COVID-19

Introduction & BackgroundPrevious studies have found shopping data could increase the predictive accuracy of disease surveillance systems and illuminate behavioural responses in the self-management of symptoms of disease. Yet, accessing individual sales datasets for linkage to health datasets is challenging, and the recruitment of appropriate sample sizes for medical research has been limited.
 Objectives & ApproachObjectivesCollect and link individual health data to individual shopping data to investigate COVID-19. Assess the feasibility of scaling-up this method, and use the collected data to investigate using loyalty card data in machine learning (ML) models for disease.
 MethodsBased on recommendations on the public’s preferences for data donation a new protocol was designed for collecting, linking and analysing shopping and health data. Participants were requested to use the Tesco Clubcard website data portability function to share their loyalty card data and complete an online health survey. An exploratory data analysis was conducted on the linked dataset. Participants were recruited online (18/01/2022 to 04/02/2022) with a recruitment target of 200.
 Relevance to Digital FootprintsThe collection and analysis of individual transactional sales data for health research.
 Results197 participants shared their Tesco Clubcard and health survey data. Tesco Clubcard data contained 893,414 transactions of 65,310 uniquely named items purchased from 2015 to 2022. Average transactions per participant were 4,653 (SD 5256) and average timeframe recorded was five years 6 months and 30 days (SD 836 days). A total of 6,993 medication sales were recorded accounting for 1% of sales, 81% (159/197) of participants bought medications and the average was 44 (STD 68) medications per individual. Most participants (196/197) shared their health status in the survey, and 94% (81/86) of those on medication shared the medication names. Participants reported donating their data to do good (79%, 155/197), help the NHS (77%, 152/197), be socially responsible (74%, 144/197) and because data was secure and anonymised (78%, 153/197).
 Conclusions & ImplicationsUsing this new protocol which enables convenient data sharing with transparent data safeguards, the public were willing to share both their shopping and health data for research into COVID-19. To apply robust ML analysis, particularly to explore self-medication at an individual level, recruitment must be significantly scaled to collect data from enough individuals with high sales and regular shopping frequency, or new ML techniques developed to address sparseness in loyalty card data of key purchasing events related to health. The study suggests public readiness to share shopping data for health research, but investment is needed for large-scale data collection and AI application.

How to Make Outpatient Healthcare Data in Germany Available for Research in the Dynamic Course of Digital Transformation.

There is increasing interest on re-use of outpatient healthcare data for research, as most medical diagnosis and treatment is provided in the ambulatory sector. One of the early projects to bring primary data from German ambulatory care into clinical research technically, organizationally and in compliance with legal demands has been the RADAR project, that is based on a broad consent and has used the then available practice information system's interfaces to extract and transfer data to a research repository. In course of the digital transformation of the German healthcare system, former standards are abandoned and new interoperability standards, interfaces and regulations on secondary use of patient data are defined, however with slow adoption by Health-IT systems. Therefore, it is of importance for all initiatives that aim at using ambulatory healthcare data for research, how to access this data in an efficient and effective way. Currently defined healthcare standards are compared regarding coverage of data relevant for research as defined by the RADAR project. We compare four architectural options to access ambulatory health data through different components of healthcare and health research data infrastructures along the technical, organizational and regulatory conditions, the timetable of dissemination and the researcher's perspective. A high-level comparison showed a high degree of semantic overlap in the information models used. Electronic patient records and practice information systems are alternative data sources for ambulatory health data - but differ strongly in data richness and accessibility. Considering the compared dimensions of architectural routes to access health data for secondary research use we conclude that data extraction from practice information systems is currently the most promising way due to data availability on a mid-term perspective. Integration of routine data into the national research data infrastructures might be enforced by convergence of to date different information models.

Life expectancy associated with different ages at diagnosis of type 2 diabetes in high-income countries: 23 million person-years of observation

The prevalence of type 2 diabetes is increasing rapidly, particularly among younger age groups. Estimates suggest that people with diabetes die, on average, 6 years earlier than people without diabetes. We aimed to provide reliable estimates of the associations between age at diagnosis of diabetes and all-cause mortality, cause-specific mortality, and reductions in life expectancy. For this observational study, we conducted a combined analysis of individual-participant data from 19 high-income countries using two large-scale data sources: the Emerging Risk Factors Collaboration (96 cohorts, median baseline years 1961-2007, median latest follow-up years 1980-2013) and the UK Biobank (median baseline year 2006, median latest follow-up year 2020). We calculated age-adjusted and sex-adjusted hazard ratios (HRs) for all-cause mortality according to age at diagnosis of diabetes using data from 1 515 718 participants, in whom deaths were recorded during 23·1 million person-years of follow-up. We estimated cumulative survival by applying age-specific HRs to age-specific death rates from 2015 for the USA and the EU. For participants with diabetes, we observed a linear dose-response association between earlier age at diagnosis and higher risk of all-cause mortality compared with participants without diabetes. HRs were 2·69 (95% CI 2·43-2·97) when diagnosed at 30-39 years, 2·26 (2·08-2·45) at 40-49 years, 1·84 (1·72-1·97) at 50-59 years, 1·57 (1·47-1·67) at 60-69 years, and 1·39 (1·29-1·51) at 70 years and older. HRs per decade of earlier diagnosis were similar for men and women. Using death rates from the USA, a 50-year-old individual with diabetes died on average 14 years earlier when diagnosed aged 30 years, 10 years earlier when diagnosed aged 40 years, or 6 years earlier when diagnosed aged 50 years than an individual without diabetes. Using EU death rates, the corresponding estimates were 13, 9, or 5 years earlier. Every decade of earlier diagnosis of diabetes was associated with about 3-4 years of lower life expectancy, highlighting the need to develop and implement interventions that prevent or delay the onset of diabetes and to intensify the treatment of risk factors among young adults diagnosed with diabetes. British Heart Foundation, Medical Research Council, National Institute for Health and Care Research, and Health Data Research UK.

Association between immigrant concentration and mental health service utilization in the United States over time: A geospatial big data analysis.

Immigrants (foreign-born United States [US] citizens) generally have lower utilization of mental health services compared with US-born counterparts, but extant studies have not investigated the disparities in mental health service utilization within immigrant population nationwide over time. Leveraging mobile phone-based visitation data, we estimated the average mental health utilization in contiguous US census tracts in 2019, 2020, and 2021 by employing two novel outcomes: mental health service visits and visit-to-need ratio (i.e., visits per depression diagnosis). We then investigated the tract-level association between immigration concentration and mental health service utilization outcomes using mixed-effects linear regression models that accounted for spatial lag effects, time effects, and covariates. This study reveals spatial and temporal disparities in mental health service visits and visit-to-need ratio among different levels of immigrant concentration across the US, both before and during the pandemic. Tracts with higher concentrations of Latin American immigrants showed significantly lower mental health service utilization visits and visit-to-need ratio, particularly in the US West. Tracts with Asian and European immigrant concentrations experienced a more significant decline in mental health service utilization visits and visit-to-need ratio from 2019 to 2020 than those with Latin American concentrations. Meanwhile, in 2021, tracts with Latin American concentrations had the least recovery in mental health service utilization visits. The study highlights the potential of geospatial big data for mental health research and informs public health interventions.

Abstract 004: Process And Health Outcomes Of Patients With Severe Hypertension In A Real-world Setting: Findings From A 12-year Study In A Large Health System

Introduction: Health systems are increasingly leveraging real-world data to improve community health outcomes. Methods: We conducted a longitudinal assessment of health outcomes in patients with severe hypertension using electronic health record data from the Sentara Healthcare System 2010-2021. Severe hypertension was defined as at least two consecutive blood pressure (BP) readings above 160/100 mmHg. We examined follow-up visit rates at 3 and 6 months, and BP control rates (<140/90 mmHg) at 6 and 12 months after the second BP elevation. We also assessed the incidence of cardiovascular disease (CVD) until the end of 2022. Results: The study included 75,657 patients with severe hypertension. Mean age was 61.5 (13.9) years; 55% were female, 57% were White, 37% were Black, and 21.3% had a history of CVD. The median follow-up time was 3.8 years. Among patients with severe hypertension, 72% and 84% had follow-up visits at 3 and 6 months; 38% and 41% achieved BP control at 6 and 12 months. Among patients without prior history of CVD, 22.5% experienced at least one cardiovascular event during the follow-up, including 8.7% with coronary arteriosclerosis, 11.9% with heart failure, 65.2% with cerebral infarction, and 3.5% with myocardial infarction. The median time to cardiovascular events was 793 days. The risk of CVD was significantly higher in Black and older patients, as well as those with blood pressure levels exceeding 180/120 mmHg. Conclusions: This study successfully identified a longitudinal digital cohort of patients with severe hypertension and linked it to health outcomes. The findings have implications for health systems utilizing real-world data in population health research.

A Datasheet for the INSIGHT Birmingham, Solihull, and Black Country Diabetic Retinopathy Screening Dataset.

Diabetic retinopathy(DR) is the most common microvascular complication associated with diabetes mellitus (DM), affecting approximately 40% of this patient population. Early detection of DR is vital to ensure monitoring of disease progression and prompt sight saving treatments as required. This article describes the data contained within the INSIGHT Birmingham, Solihull, and Black Country Diabetic Retinopathy Dataset. Dataset descriptor for routinely collected eye screening data. All diabetic patients aged 12 years and older, attending annual digital retinal photography-based screening within the Birmingham, Solihull, and Black Country Eye Screening Programme. The INSIGHT Health Data Research Hub for Eye Health is a National Health Service (NHS)-led ophthalmic bioresource that provides researchers with safe access to anonymized, routinely collected data from contributing NHS hospitals to advance research for patient benefit. This report describes the INSIGHT Birmingham, Solihull, and Black Country DR Screening Dataset, a dataset of anonymized images and linked screening data derived from the United Kingdom's largest regional DR screening program. This dataset consists of routinely collected data from the eye screening program. The data primarily include retinal photographs with the associated DR grading data. Additional data such as corresponding demographic details, information regarding patients' diabetic status, and visual acuity data are also available. Further details regarding available data points are available in the supplementary information, in addition to the INSIGHT webpage included below. At the time point of this analysis (December 31, 2019), the dataset comprised 6 202 161 images from 246 180 patients, with a dataset inception date of January 1, 2007. The dataset includes 1 360 547 grading episodes between R0M0 and R3M1. This dataset descriptor article summarizes the content of the dataset, how it has been curated, and what its potential uses are. Data are available through a structured application process for research studies that support discovery, clinical evidence analyses, and innovation in artificial intelligence technologies for patient benefit. Further information regarding the data repository and contact details can be found at https://www.insight.hdrhub.org/. Proprietary or commercial disclosure may be found after the references.

A Datasheet for the INSIGHT University Hospitals Birmingham Retinal Vein Occlusion Data Set.

Retinal vein occlusion (RVO) is the second leading cause of visual loss due to retinal disease. Retinal vein occlusion increases the risk of cardiovascular mortality and the risk of stroke. This article describes the data contained within the INSIGHT eye health data set for RVO and cardiovascular disease. Data set descriptor for routinely collected eye and systemic disease data. All people who had suffered an RVO aged ≥ 18 years old, attending the Ophthalmology Clinic at Queen Elizabeth Hospital, University Hospitals Birmingham (UHB) National Health Service (NHS) Trust were included. The INSIGHT Health Data Research Hub for Eye Health is an NHS-led ophthalmic bioresource. It provides researchers with safe access to anonymized routinely collected data from contributing NHS hospitals to advance research for patient benefit. This report describes the INSIGHT UHB RVO and major adverse cardiovascular events data set, a data set of ophthalmology and systemic data derived from the United Kingdom's largest acute care trust. This data set consists of routinely collected data from the hospital's electronic patient records. The data set primarily includes structured data (relating to their hospital eye care and any cardiovascular data held for the individual) and OCT ocular images. Further details regarding the available data points are available in the supplementary information. At the time point of this analysis (September 30, 2022) the data set was composed of clinical data from 1521 patients, from Medisoft records inception. The data set includes 2196 occurrences of RVO affecting 2026 eyes, longitudinal eye follow-up clinical parameters, over 6217 eye-related procedures, and 982 encountered complications. The data set contains information on 2534 major adverse cardiovascular event occurrences, their subtype, number experienced per patient, and chronological relation to RVO event. Longitudinal follow-up data including laboratory results, regular medications, and all-cause mortality are also available within the data set. This data set descriptor article summarizes the data set contents, the process of its curation, and potential uses. The data set is available through the structured application process that ensures research studies are for patient benefit. Further information regarding the data repository and contact details can be found at https://www.insight.hdrhub.org/. Proprietary or commercial disclosure may be found after the references.

Trajectories in chronic disease accrual and mortality across the lifespan in Wales, UK (2005-2019), by area deprivation profile: linked electronic health records cohort study on 965,905 individuals.

Understanding and quantifying the differences in disease development in different socioeconomic groups of people across the lifespan is important for planning healthcare and preventive services. The study aimed to measure chronic disease accrual, and examine the differences in time to individual morbidities, multimorbidity, and mortality between socioeconomic groups in Wales, UK. Population-wide electronic linked cohort study, following Welsh residents for up to 20 years (2000-2019). Chronic disease diagnoses were obtained from general practice and hospitalisation records using the CALIBER disease phenotype register. Multi-state models were used to examine trajectories of accrual of 132 diseases and mortality, adjusted for sex, age and area-level deprivation. Restricted mean survival time was calculated to measure time spent free of chronic disease(s) or mortality between socioeconomic groups. In total, 965,905 individuals aged 5-104 were included, from a possible 2.9m individuals following a 5-year clearance period, with an average follow-up of 13.2 years (12.7 million person-years). Some 673,189 (69.7%) individuals developed at least one chronic disease or died within the study period. From ages 10 years upwards, the individuals living in the most deprived areas consistently experienced reduced time between health states, demonstrating accelerated transitions to first and subsequent morbidities and death compared to their demographic equivalent living in the least deprived areas. The largest difference were observed in 10 and 20 year old males developing multimorbidity (-0.45 years (99% CI:-0.45,-0.44)) and in 70 year old males dying after developing multimorbidity (-1.98 years (99% CI:-2.01,-1.95)). This study adds to the existing literature on health inequalities by demonstrating that individuals living in more deprived areas consistently experience accelerated time to diagnosis of chronic disease and death across all ages, accounting for competing risks. UK Medical Research Council, Health Data Research UK, and Administrative Data Research Wales.

Hubungan Pengetahuan dan Motivasi Mahasiswa Terhadap Upaya Pencegahan Kanker Serviks di Stikes Yahya Bima

Background: According to Basic Health Research data for 2018, the prevalence of cancer in Indonesia shows an increase from 1.4 per 1000 population in 2013 to 1.79 per 1000 population in 2018. Purpose: To determine the relationship between student knowledge and motivation towards cervical cancer prevention at STIKES Yahya Bima. Method: The type of research used in this research is an analytical survey with a cross-sectional approach. Research subjects were students who met the inclusion criteria. Determination of the sample was done by purposive sampling. Data were obtained from questionnaires and analyzed univariately and bivariately. Univariate analysis in the form of frequency distribution is presented in table form using the Chi Square test. Results: The level of knowledge of students at STIKES Yahya Bima regarding efforts to prevent cervical cancer was obtained with a value of ρ = 0.001. Thus, Ho is rejected, Ha is accepted or there is a relationship between the level of student knowledge and efforts to prevent cervical cancer. Student motivation at STIKES Yahya Bima towards cervical cancer prevention efforts obtained a value of ρ = 0.003 Thus Ho is rejected Ha is accepted or there is a relationship between student motivation and cervical cancer prevention efforts.

Patient and public involvement to inform priorities and practice for research using existing healthcare data for children’s and young people’s cancers

BackgroundIn the United Kingdom, healthcare data is collected on all patients receiving National Health Service (NHS) care, including children and young people (CYP) with cancer. This data is used to inform service delivery, and with special permissions used for research. The use of routinely collected health data in research is an advancing field with huge potential benefit, particularly in CYP with cancer where case numbers are small and the impact across the life course can be significant.Patient and public involvement (PPI) exercise aims:Identify current barriers to trust relating to the use of healthcare data for research.Determine ways to increase public and patient confidence in the use of healthcare data in research.Define areas of research importance to CYP and their carers using healthcare data.MethodsYoung people currently aged between 16 and 25 years who had a cancer diagnosis before the age of 20 years and carers of a young person with cancer were invited to take part via social media and existing networks of service users. Data was collected during two interactive online workshops totalling 5 h and comprising of presentations from health data experts, case-studies and group discussions. With participant consent the workshops were recorded, transcribed verbatim and analysed using thematic analysis.ResultsTen young people and six carers attended workshop one. Four young people and four carers returned for workshop two. Lack of awareness of how data is used, and negative media reporting were seen as the main causes of mistrust. Better communication and education on how data is used were felt to be important to improving public confidence. Participants want the ability to have control over their own data use. Late effects, social and education outcomes and research on rare tumours were described as key research priorities for data use.ConclusionsIn order to improve public and patient trust in our use of data for research, we need to improve communication about how data is used and the benefits that arise.

Community perceptions on the effectiveness of herbal medicines and factors associated with their use in managing diarrhoea among under-five children in North-eastern Tanzania

BackgroundThe demand for herbal medicines continues to increase globally. However, community perceptions on their effectiveness and factors influencing their use have not been extensively investigated, notably in the Tanga Region, North-eastern Tanzania, where their use in treating various diseases, including paediatric diarrhoea, has flourished. According to studies, Tanga Region has a high prevalence of diarrhoea among under-five children. This study explored community perceptions on the effectiveness of herbal medicines and factors associated with their use in managing diarrhoea among under-five children in North-eastern Tanzania.MethodsA qualitative approach and a narrative design were employed by the present study since they had the potential to reveal unrecognized or unreported research problems. Focus group discussions and in-depth interviews were used to facilitate data collection from June 2022 to February 2023. The methods were chosen since they are the most common sources of qualitative data in health research. Purposive sampling method was used to select 247 participants, which included 171 caretakers, 52 traditional healers, and 24 paediatric health workers. Interviews were conducted until the saturation point was reached. The purposive technique was considered since it was a method that enabled the researcher to select participants who were knowledgeable about the study topic. Data analysis was performed using thematic analysis.ResultsEconomic hardship, culture and heritage, superstitious beliefs, failure to recover after receiving hospital medication, easy accessibility of herbal medicines, and long distance to the health facility were the factors perceived to be potentially associated with persistent use of herbal medicines among caretakers. The majority of participants believed that herbal treatments were harmless and effective in treating diarrhoea.ConclusionSuperstitious beliefs, culture, and heritage were the primary justifications for using herbal medicines. It is vital for the relevant authority to educate the community on the risk of using unproven herbal medicines in order to diminish the effects that may arise from using uninvestigated herbs. As things stand, the use of herbal medications will continue owing to their relevance to the lives of people in the study setting.

Socialization of Balanced Nutrition with Comic Media and Assistance for Urban Gardening in Waiheru Village

Basic Health Research data from the Ministry of Health of the Republic of Indonesia in 2018 showed that nationally the problem of central obesity at the age of 15 years was still serious, namely, 31%, while the prevalence of central obesity at the age of 15 years in Maluku reached 33%. Obesity is becoming a health problem worldwide; even the WHO states that obesity has become a global epidemic. Obesity is a health problem that must address immediately because it is a risk factor for degenerative diseases and metabolic syndrome. Obesity in adolescents needs to get serious attention, be consistent, and be addressed together. To improve health status and optimize adolescent growth and development, it is necessary to apply a healthy diet through the socialization of balanced nutrition with comic media and implementation assistance. Urban gardening for teenagers through mosque youth can be an effort to implement healthy eating patterns for teenagers for optimal nutrition and health status.

Healthcare in England was affected by the COVID-19 pandemic across the pancreatic cancer pathway: A cohort study using OpenSAFELY-TPP.

Healthcare across all sectors, in the UK and globally, was negatively affected by the COVID-19 pandemic. We analysed healthcare services delivered to people with pancreatic cancer from January 2015 to March 2023 to investigate the effect of the COVID-19 pandemic. With the approval of NHS England, and drawing from a nationally representative OpenSAFELY-TPP dataset of 24 million patients (over 40% of the English population), we undertook a cohort study of people diagnosed with pancreatic cancer. We queried electronic healthcare records for information on the provision of healthcare services across the pancreatic cancer pathway. To estimate the effect of the COVID-19 pandemic, we predicted the rates of healthcare services if the pandemic had not happened. We used generalised linear models and the pre-pandemic data from January 2015 to February 2020 to predict rates in March 2020 to March 2023. The 95% confidence intervals of the predicted values were used to estimate the significance of the difference between the predicted and observed rates. The rate of pancreatic cancer and diabetes diagnoses in the cohort was not affected by the pandemic. There were 26,840 people diagnosed with pancreatic cancer from January 2015 to March 2023. The mean age at diagnosis was 72 (±11 SD), 48% of people were female, 95% were of White ethnicity, and 40% were diagnosed with diabetes. We found a reduction in surgical resections by 25-28% during the pandemic. In addition, 20%, 10%, and 4% fewer people received body mass index, glycated haemoglobin, and liver function tests, respectively, before they were diagnosed with pancreatic cancer. There was no impact of the pandemic on the number of people making contact with primary care, but the number of contacts increased on average by 1-2 per person amongst those who made contact. Reporting of jaundice decreased by 28%, but recovered within 12 months into the pandemic. Emergency department visits, hospital admissions, and deaths were not affected. The pandemic affected healthcare in England across the pancreatic cancer pathway. Positive lessons could be learnt from the services that were resilient and those that recovered quickly. The reductions in healthcare experienced by people with cancer have the potential to lead to worse outcomes. Current efforts should focus on addressing the unmet needs of people with cancer. This work was jointly funded by the Wellcome Trust (222097/Z/20/Z); MRC (MR/V015757/1, MC_PC-20059, MR/W016729/1); NIHR (NIHR135559, COV-LT2-0073), and Health Data Research UK (HDRUK2021.000, 2021.0157). This work was funded by Medical Research Council (MRC) grant reference MR/W021390/1 as part of the postdoctoral fellowship awarded to AL and undertaken at the Bennett Institute, University of Oxford. The views expressed are those of the authors and not necessarily those of the NIHR, NHS England, UK Health Security Agency (UKHSA), or the Department of Health and Social Care. Funders had no role in the study design, collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.

Peranan Pemerintah Desa dalam Pencegahan Stunting di Desa Aek Mual Kecamatan Siabu Kabupaten Mandailing Natal Tahun 2023

Based on Basic Health Research data for 2019, the stunting rate in Indonesia is 27.67%. According to WHO, a public health problem is considered chronic when the prevalence of stunting exceeds 20%. Villages are required to develop programs or activities related to stunting prevention. So the researchers wanted to know the role of the village government of Aek Mual in preventing stunting, so the researchers conducted research on the role of the village government in preventing stunting in Aek Mual Village, Siabu District in 2023. The technique for selecting research subjects was carried out by purposive sampling, which obtained several subjects, namely village officials. Aek Nausea, mothers who have toddlers and village midwives. Data collection techniques were carried out by direct interviews with informants using interview guidelines. From the results of the study it can be concluded that the role of the village government in preventing stunting, especially health, has been carried out well. Both the allocation of funds and the actions and ideas made by the Aek Mual Village Government have prevented Aek Mual Village from stunting, the village government's efforts such as providing additional food, carrying out toddler sweeping activities, child immunization and providing additional food to pregnant women.

Antipsychotic drug prescribing and mortality in people with dementia before and during the COVID-19 pandemic: a retrospective cohort study in Wales, UK

Concerns have been raised that antipsychotic drug prescribing, which has been associated with increased mortality in people with dementia, might have increased during the COVID-19 pandemic due to social restrictions imposed to limit the spread of SARS-CoV-2. We used multisource, routinely collected health-care data from Wales, UK to investigate prescribing and mortality variations in people with dementia before and during the COVID-19 pandemic. In this retrospective cohort study, we used individual-level, anonymised, population-scale linked health data to identify adults aged 60 years and older with a diagnosis of dementia in Wales, UK. We used the CVD-COVID-UK initiative to access Welsh routinely collected electronic health record data from the Secure Anonymised Information Linkage (SAIL) Databank. Patients who were alive and registered with a SAIL general practice on Jan 1, 2016, and who received a dementia diagnosis before the age of 60 years and before or during the study period were included. We explored antipsychotic drug prescribing rate changes over 67 months, between Jan 1, 2016, and Aug 1, 2021, overall and stratified by age and dementia subtype. We used time-series analyses to examine all-cause and myocardial infarction and stroke mortality over the study period and identified the leading causes of death in people with dementia between Jan 1, 2020, and Aug 1, 2021. Of 3 106 690 participants in SAIL between Jan 1, 2016 and Aug 1, 2021, 57 396 people (35 148 [61·2%] women and 22 248 [38·8%] men) met inclusion criteria for this study and contributed 101 428 person-years of follow-up. Of the 57 396 people with dementia, 11 929 (20·8%) were prescribed an antipsychotic drug at any point during follow-up. Accounting for seasonality, antipsychotic drug prescribing increased during the second half of 2019 and throughout 2020. However, the absolute difference in prescribing rates was small, ranging from 1253 prescriptions per 10 000 person-months in March, 2019, to 1305 per 10 000 person-months in September, 2020. All-cause mortality and stroke mortality increased throughout 2020, while myocardial infarction mortality declined. From Jan 1, 2020, to Aug 1, 2021, 1286 (17·1%) of 7508 participants who died had COVID-19 recorded as the underlying cause of death. During the COVID-19 pandemic, antipsychotic drug prescribing in people with dementia in the UK increased slightly; however, it is unlikely that this was solely related to the pandemic and this increase was unlikely to be a major factor in the substantial increase in mortality during 2020. The long-term increase in antipsychotic drug prescribing in younger people and in those with Alzheimer's disease warrants further investigation using resources with access to more granular clinical data. Although deprescribing antipsychotic medications remains an essential aspect of dementia care, the results of this study suggest that changes in prescribing and deprescribing practices as a result of the COVID-19 pandemic are not required. British Heart Foundation (via the British Heart Foundation Data Science Centre led by Health Data Research UK), and the Scottish Neurological Research Fund.

Eleven key measures for monitoring general practice clinical activity during COVID-19: A retrospective cohort study using 48 million adults' primary care records in England through OpenSAFELY.

The COVID-19 pandemic has had a significant impact on delivery of NHS care. We have developed the OpenSAFELY Service Restoration Observatory (SRO) to develop key measures of primary care activity and describe the trends in these measures throughout the COVID-19 pandemic. With the approval of NHS England, we developed an open source software framework for data management and analysis to describe trends and variation in clinical activity across primary care electronic health record (EHR) data on 48 million adults.We developed SNOMED-CT codelists for key measures of primary care clinical activity such as blood pressure monitoring and asthma reviews, selected by an expert clinical advisory group and conducted a population cohort-based study to describe trends and variation in these measures January 2019-December 2021, and pragmatically classified their level of recovery one year into the pandemic using the percentage change in the median practice level rate. We produced 11 measures reflective of clinical activity in general practice. A substantial drop in activity was observed in all measures at the outset of the COVID-19 pandemic. By April 2021, the median rate had recovered to within 15% of the median rate in April 2019 in six measures. The remaining measures showed a sustained drop, ranging from a 18.5% reduction in medication reviews to a 42.0% reduction in blood pressure monitoring. Three measures continued to show a sustained drop by December 2021. The COVID-19 pandemic was associated with a substantial change in primary care activity across the measures we developed, with recovery in most measures. We delivered an open source software framework to describe trends and variation in clinical activity across an unprecedented scale of primary care data. We will continue to expand the set of key measures to be routinely monitored using our publicly available NHS OpenSAFELY SRO dashboards with near real-time data. This research used data assets made available as part of the Data and Connectivity National Core Study, led by Health Data Research UK in partnership with the Office for National Statistics and funded by UK Research and Innovation (grant ref MC_PC_20058).The OpenSAFELY Platform is supported by grants from the Wellcome Trust (222097/Z/20/Z); MRC (MR/V015757/1, MC_PC-20059, MR/W016729/1); NIHR (NIHR135559, COV-LT2-0073), and Health Data Research UK (HDRUK2021.000, 2021.0157).