National Identification Number Research Articles

Time trends in mortality, incidence and case-fatality of acute myocardial infarction in Norway - do we see the end of the coronary heart disease epidemic?

Abstract Background In Norway and most industrialized countries the mortality rates from acute myocardial infarction (AMI) increased after World War II, peaked in the 1960s – 1970s, and have since that time declined (Figure). Recent studies have suggested that the decline may have leveled off, and that the favourable trends do not include younger age groups, possibly due obesity and diabetes. Also, the relative contribution of a reduction in incidence and improved case-fatality rates (CFR) to the AMI mortality trends are not known with certainty. We examined mortality trends of AMI in Norway during 1951 – 2021, and the incidence and CFR of hospitalized and non-hospitalized AMI during 2013-2021. Methods Fatal AMI cases were identified in the National Causes of Death Registry. Norwegian hospitals are required by law to register all patients hospitalized for AMI in the Norwegian AMI Registry. Hospitalized cases not registered in the AMI registry were retrieved from the Norwegian Patient Registry which contains discharge diagnoses for hospitalized patients. The national unique 11-digit identification number allowed linkage of the registries and identification of transfers between hospitals and re-hospitalizations. An AMI (either hospitalization or death) was classified as incident if no hospitalization was found for that individual during the previous 5 years. We calculated age-adjusted rates with the Norwegian population in 2017 as standard. Results Norwegian AMI mortality rates increased from 1951, peaked in the late 1960s, and have since that time declined steadily, although steeper after around 1990 (Figure). Present AMI mortality rates are lower than in the 1950s, and are still declining. Incidence of AMI (hospitalized and non-hospitalized) fell from 391/100 000 in 2013 to 271/100 000 in 2021, corresponding to a mean reduction of 3.6 % per year (p<0.001). Incidence of out-of-hospital fatal AMI fell by 6.5 % per year, incidence of hospitalized ST-segment elevation AMI (STEMI) fell by 2.3 % per year, and incidence of non-ST-segment elevation AMI (NSTEMI) fell by 3.1 % per year (all p<0.001). 30-days CFR of hospitalized and non-hospitalized AMI fell from 21.3 % in 2013 to 17.5 % (3.6 % per year; p<0.001). CFR after NSTEMI fell from 8.2 % in 2013 to 6.4 % in 2021 (4.4 % per year; p<0.001), whereas there was no significant change in CFR after STEMI (13.3 % in 2013 and 12.0 % in 2021). The incidence and CFR trends were similar in men and women aged 20-49, 50-79 and 80+ years. Comments Declining incidence of out-of-hospital fatal AMI and declining incidence of hospitalized STEMI and NSTEMI were major contributors to the declining AMI mortality rates in Norway. Improved case-fatality rates among hospitalized patients have contributed to the declining mortality rates, but there was no improvement in case-fatality in STEMI during 2013-2021.

Barriers to Enrolment into Health Insurance Schemes in Nigeria: The case of Niger State Contributory Health Insurance Scheme

Niger State government has keyed into the health insurance program of the federal government since 2019, with the establishment of the Niger State Health Insurance Scheme. Although the scheme has beautiful mission for the formal and the informal sector workers as well as the students in tertiary institutions and the vulnerable groups, it is yet to enjoy reasonable patronage. Studies on barriers to enrolment into health insurance were mostly conducted in matured health insurance settings, where barriers to enrolment do with operational concerns. It is not clear whether operational concerns may affect enrolment in Niger State where the health insurance scheme is at the take-off stage. Using qualitative research design to explore the enrolment barriers, this study has drawn a sample of 22 respondents across the major tribes, religions, enrolment category and senatorial zones of the state. Four enrolment officers were also part of the respondents. An in-depth interview was conducted on the respondent and the results were analysed in themes. The findings of the study showed that lack of trust in anything government is the major barrier to enrolment among the public sector workers due to their prior experiences of failed schemes run by government. However, inadequate sensitization about the requirements, procedures for enrolment, cost and benefits of the scheme were the barriers to enrolment among the informal and the private sector workers. The enrolment of the vulnerable groups is undermined by the lack of social register from where the list of the qualified people would be extracted. In addition, the lack of National Identification Number, which is the pre-requisite for enrolment, deters enrolment of the vulnerable groups. The problem of insecurity in the state also affects outreach and enrolment. Necessary suggestions are given to the government.

Factors Influencing SIMRS Quality at Al-Islam H.M Mawardi General Hospital

This quantitative study investigates the impact of organizational factors on Hospital Management Information Systems (HMIS), employing the PRISM framework. The absence of a search menu linked to the primary key of national identity number in the HMIS was scrutinized for its effects. Results reveal significant influences of organizational factors on technical and behavioral aspects of HMIS. Notably, periodic evaluations by the IT team significantly enhance technological advancements within hospitals, while frequent training sessions for HMIS users markedly improve their comprehension of system functionalities. These findings underscore the pivotal role of organizational strategies in shaping the effectiveness and efficiency of HMIS, offering valuable insights for optimizing healthcare information management practices. Highlights : Organizational factors significantly influence technical enhancements in Hospital Management Information Systems. Frequent evaluations by the IT team contribute to technological advancements within hospital systems. Regular user training sessions enhance comprehension and utilization of HMIS functionalities Keywords: Hospital Management Information Systems, Organizational Factors, PRISM Analysis, Technology Improvement, User Training

Permutation of National Identification Number for a Better Security in Communication Channel

This study proposes a new method to enhance the security of transmitting national identification number via various communication channels like SMS, email, and Box office. It introduces a permutation technique utilizing the Gamma 1 Non-Deranged Permutation group, ensuring the confidentiality of the information. By employing 11 factorial (11!) permutations, the national identification number is transformed into a mixed format for unintended recipients, yet remains easily decrypted by the intended recipient. This approach mitigates concerns regarding data interception and unauthorized access, providing a robust solution for secure information transmission across diverse media channels.

Auth4App: Streamlining authentication for integrated cyber–physical environments

The growing integration of mobile applications for user authentication has revolutionized user interactions with digital platforms, offering novel possibilities in user experience (UX). However, this paradigm shift poses significant security challenges. Leveraging smartphones for authentication purposes provides convenient and swift access to services, streamlining user interactions with various platforms through simple taps. Several institutions adopt static QR Codes generated from primary, unchanging user data (e.g., individual citizen national identification numbers) for physical authentication procedures like access turnstiles. However, relying on static data introduces critical security vulnerabilities as this data is susceptible to compromise. Implementing an One-Time Authentication Code (OTAC) approach appears promising in addressing these issues. Nevertheless, the absence of an integrated solution for developing a physical authentication process using OTAC leads to suboptimal API user experiences (UX APIs) and subsequent security vulnerabilities. In response to this challenge, we introduce Auth4App, a protocol set designed for identification and authentication using mobile applications. Auth4App comprises two core protocols: one dedicated to linking user credentials to mobile devices (i.e., identification), and the other for generating OTAC. We showcase the adaptability and practicality of Auth4App through three distinct case studies: a mobile-only scenario, integration of mobile devices with a turnstile, and integration of Auth4App with FIDO2. To ensure the robustness of the security protocols, Auth4App is evaluated using automated verification tools and argument proofs, solidifying the system’s reliability.

#1923 Anticoagulation and risk of stroke in patients with incident atrial fibrillation and CKD stages 4-5—results from the nationwide FinACAF study

Abstract Background and Aims Atrial fibrillation (AF) is common in patients with chronic kidney disease (CKD). It is well known that CKD in AF patients increases the risk of thromboembolic complications, and also bleeding. However, there is lack of safety and efficacy data of oral anticoagulation (OAC) in patients with advanced CKD. Method The FinACAF study includes data from 411 000 patients covering all Finnish AF patients from 2004 to 2018. Using national unique personal identification numbers, individual patients’ data from several registries and laboratory databases were linked together. The inclusion criteria of this study were all patients 20 years or older with a new-onset, non-valvular AF between 2010 and 2018 and a measured estimated glomerular filtration rate (eGFR) within the proximity of the AF diagnosis. Risk of stroke in patients with CKD stages 4-5 (eGFR < 30 ml/min/1.73 m2) was evaluated. Patients on dialysis and those with functioning graft were excluded. Participants were followed for the occurrence of ischemic stroke (IS) until December 31st 2018 or until death or until the OAC exposure reached a maximum duration of 730 days, whichever came first. The follow-up period was capped at 730 days due to the limited number of patients with direct oral anticoagulation (DOAC) exposure exceeding 730 days. Hazard ratios [95% confidence intervals (CI)] comparing different OACs or no OAC were derived from the Cox regression model. Results The study cohort included 4148 patients. The mean (SD) eGFR was 21.5 (6.7) ml/min/1.73 m2. 1940 patients had no OAC, 1658 patients had warfarin and 550 patients had any DOAC (396 apixaban, 121 rivaroxaban, 17 dabigatran and 16 edoxaban). During the follow-up 146 patients (3.5%) had ischemic stroke. Compared to patients with no OAC (reference) HRs were 0.42 [95% CI 0.30-0.59)] for the patients with warfarin and 0.28 [95% CI 0.01-0.52)] for the patients with DOACs. Cumulative hazards for ischemic stroke are shown in the Figure. Conclusion Among patients with incident AF and advanced CKD, the risk of stroke was lowest in patients with DOACs and the worst in patients with no OAC. Warfarin users were positioned in between these two groups. Further analysis is needed to evaluate also the safety of different OACs in our cohort.

Face Recognition and Identification System for Crime Detection Using Python Programming Language

Abstract: Throughout the years, finding criminals has posed a challenging endeavor. In the past, the method relied on leads derived from evidence discovered at the crime scene. Genetic evidence is comparatively straightforward to trace, yet wrongdoers have grown increasingly proficient at obscuring their trail and leaving behind no discernible mark. To address this issue, a face recognition system for crime detection was developed. In this study, a qualitative method was used to collect the face images of criminals in collaboration with law enforcement agencies. An API was built using the criminals National Identification Numbers. Then, a face recognition view that returns the object of the user gotten from the National Identification Number was built. The returned user objects (including face images of the user) underwent preprocessing steps, including normalization, resizing, and noise removal, to enhance the quality and standardize the facial features. Local Binary Patterns algorithm in Python OpenCV library was applied to the preprocessed face images to extract discriminative features from the preprocessed face images. These features aimed to capture the unique characteristics of each face for subsequent recognition. The algorithm was trained on the extracted features and tested given a new input image. The interface component specification of the system was designed using HTML, CSS, and JavaScript client-side technologies.

Data Collection Module for a Centralized Electronic Health Records System

Electronic Health Records (EHRs) play a crucial role in modern healthcare, enhancing quality, safety, efficiency, and research capabilities. However, in Nigeria the full acceptance of such modern ways of managing healthcare delivery is marred with various challenges such as infrastructure, funding, technical expertise, and regulatory issues. This paper presents a proposed conceptual framework of a Data Collection Module for a Centralized EHR System in Nigeria, aimed at addressing data accessibility challenges faced by healthcare facilities for patients registering at their facilities. The module utilizes National Identification Numbers (NINs), barcodes, and biometric identification methods to collect and secure patient demographic data. It incorporates a web application, biometric software, and barcode/QR code software to ensure efficient data collection and verification. Our study demonstrates the feasibility and effectiveness of employing biometric identification techniques in data collection modules, offering enhanced accuracy, reliability, security, and usability of patient data in a developing healthcare system like Nigeria.The proposed module has not been tested in a real-world environment, so more study is required to determine its viability, scalability, and effect on the standard and results of healthcare.

Application of Criminal Offenders Misuse of National Identification Numbers for Phone Card Registration in Makassar City

The research aims to investigate the protection of privacy rights for SIM card users under the registration system and identify obstacles faced by individuals misusing others' National Identification Numbers (NIK) without consent. This study employs a combination of normative legal research and empirical legal research, focusing on telecommunications businesses in Makassar City, South Sulawesi Province. Data collection involves primary and secondary sources. The findings indicate that despite the absence of specific laws on starter pack registration, Indonesian citizens are protected by constitutional, administrative, ITE (Information and Electronic Transactions), and personal data protection laws. However, obstacles exist in enforcing criminal offenses related to NIK misuse, including outlet registration by actors lacking buyer identities due to fierce competition and public preference for instant solutions without considering the consequences of using others' NIK for SIM card registration.

Intermediaries as infrastructure: Interrogating the phatic labor of state-building

Investments in the digital welfare state are often driven by the promise of removing intermediaries between the state and citizens, yet they continue to play a key role in the last mile delivery of state services. By intermediaries, I mean people who interface between bureaucrats and citizens. Their work, often as proxies for citizens, is not only to simplify bureaucratic procedures for them, but also help insulate them from bureaucratic apathy. Based on 18-months of ethnographic fieldwork, I describe the work of intermediaries around government offices, who (in)visibly support citizens in navigating the bureaucratic procedures of enrolling into Aadhaar, India's biometrics-based national identity number. Building on Julia Elyachar's conception of “phatic labor,” I position such intermediaries themselves as infrastructure and illustrate how their affective networks can be leveraged to orchestrate a form of distributive justice to ensure that being marginal does not preclude a citizen's access to welfare services.

Five-Year Survival Analysis and Causes of Late Deaths of Infants Admitted to the Tertiary Newborn Intensive Care in Latvia.

Background and Objectives: Studies on long-term survival following admission to neonatal intensive care units (NICUs) are scarce. The aim of this study was to analyse the epidemiology, five-year survival, and causes of late death of infants admitted to the only tertiary NICU in Latvia. Materials and Methods: The study population included all newborns admitted to the Children's Clinical University Hospital (CCUH) NICU from 1 January 2013 to 31 December 2017. The unique national identity numbers from the infants or their mothers were used to link the CCUH electronic medical records to the Medical Birth Register and the Database of Causes of Death of Inhabitants of Latvia maintained by The Centre for Disease Prevention and Control of Latvia. Results: During the study period, a total of 2022 patients were treated in the tertiary NICU. The average admission rate was 18.9 per 1000 live births per year. One hundred and four patients (5.1%) died in the tertiary NICU before hospital discharge. A total of 131 (6.5%) patients from the study cohort died before 12 months of age and 143 (7.1%) before 5 years of age. Patients with any degree of prematurity had a lower five-year mortality (0.9%, 9 out of 994 discharged alive) than term infants (3.2%, 30 out of 924 discharged alive; p < 0.001). Of the 39 patients who died after discharge from the NICU, the most common causes of death were congenital heart disease 35.9% (n = 14), multiple congenital malformations and chromosomal abnormalities 17.9% (n = 7), cerebral palsy 10.3% (n = 4), and viral infections 7.7% (n = 3). Conclusions: We observed increased mortality up to five years following NICU admission in both premature and term infants. These findings will help to guide the NICU follow-up programme.

Institutional Corruptionand Economic performance Nexus:AnEmpirical analysis with evidence from Nigeria

Corruption has emerged as a multifaceted challenge severely impacting the Nigerian economy in recent times. The impetus behind this study stems from the recognition that no sector, whether private, public, local or traditional institution can claim to be free from corruption. The primary objective is to examine the potential repercussions of institutional corruption on the productive performance of the Nigerian economy. Employing the Ordinary Least Squares (OLS) methodology and rooted in the endogenous growth theory, the study underscores that corruption is a hindrance to economic performance in Nigeria, as supported by evidence-based research and documented cases of corrupt practices in the country.In summary, the comprehensive view reveals that corruption detrimentally affects Nigeria's economic performance in various aspects. The study concludes that the effectof corruption on the productive performance of Nigeria is alarming and has manifested adverseconsequences for the economyand if Nigeria fails to combat corruption, the nation risks facing dire consequences due to its pervasive presence.The policy recommendations emphasizedthatthe Nigeria government should streamline and harmonize all forms of monetary transactions and payments in the country using the treasury single account (TSA), National identification number (NIN), the bank verification number (BVN) and all forms of electronic payment systems into a single digital platform and link such digital platform with the various anti-graft agencies for periodic monitoring. This will drastically reduce corruption and transactions with physical cash.Secondly, the Nigerian governmentshouldto demonstrate the political will to prosecute individuals involved in corrupt practices, regardless of their tribe, religion, or political affiliation. Such stringent actions are crucial as deterrents for others. These findings align with the ongoing institutional restructuring agenda widely advocated in Nigeria.

Determinant factors of stunting in children 2-5 years in West Aceh District, Indonesia

The prevalence of stunting in children under five years of age in Indonesia, and Aceh in particular, is still very high. This condition affects the quality of human resources and future economic growth. This study examined the determinants of stunting among children under five years of age 24-59 months in West Aceh District, Aceh Province, Indonesia. The research method was a cross-sectional study design, using secondary data from the EPPGBM and PIS-PK data from the Health Center in 2020. The sample comprised 386 families with children under five. Data were collected through documentation studies from PIS-PK data and stunting data from the E-PPGBM data. Family data matching was performed using the National Identity Number (NIN). Statistical analysis was performed using a Multiple Logistic Regression test with 95% confidence interval (CI). The results showed a significant association between exclusive breastfeeding (OR= 2,81; p= 0,010), latrine use (OR=1,73; p= 0,043), and smoking (OR= 1,62; p= 0,022) with the prevalence of stunting. Furthermore, exclusive breastfeeding was a determining factor for the incidence of stunting in toddlers (OR= 2,36; p= 0,010). In conclusion, exclusive breastfeeding practices are a determinant factor of stunting in children under five in West Aceh, so structured efforts need to be made to increase exclusive breastfeeding coverage by strengthening nutrition counseling and breastfeeding preparation for pregnant women up to two years.

Maternal Smoking During Pregnancy and Offspring's Risk for Bone Fracture in Childhood and Adolescence.

Conditions during gestation, such as maternal smoking, may affect offspring's bone structure. This could increase the offspring's risk of bone fractures during childhood. In this study, we aimed to assess the association between prenatal exposure to maternal smoking and childhood bone fracture risk. We used a register-based birth cohort that included all children born in Finland between January 1987 and September 1990. After exclusions, the final study population consisted of 220,699 persons. Using a unique national identification number, we linked the cohort data to the fracture diagnosis in specialty care and covariate data using the Medical Birth Register (MBR), Statistics Finland and Care Register for Health Care (CRHC). The fractures were analyzed in three groups: all fractures, non-high-energy fractures, and high-energy fractures. The analyses were adjusted for sex, parity, child's year of birth, mother's age at childbirth, mother's and father's educational level, and mother's fracture status. We tested the association in three age groups: <1 year, 1-<5 years, and 5-<15 years using Cox and (recurrent fractures) Poisson regression. A total of 18,857 (8.5%) persons had at least one bone fracture diagnosis before the age of 15 years. In the age group 5-<15 years, maternal smoking during pregnancy was associated with higher fracture risk in all of the studied fracture groups: hazard ratio (HR) = 1.12 (95% confidence interval [CI] 1.06-1.17) in all fractures, 1.13 (95% CI 1.07-1.19) in non-high-energy, and 1.15 (95% CI 1.00-1.32) in high-energy fractures. There were no significant associations in other age groups in any of the fracture groups. No statistically significant association between maternal smoking during pregnancy and offspring's risk of recurrent fractures was found. In conclusion, 5- to 15-year-olds whose mothers have smoked during pregnancy have an increased risk of bone fractures treated in specialty care. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).

An EMR-Based Approach to Determine Frequency, Prescribing Pattern, and Characteristics of Patients Receiving Drugs with Pharmacogenomic Guidelines.

(1) Background: This retrospective analysis utilizing electronic medical record (EMR) data from a tertiary integrated health system sought to identify patients and prescribers who would benefit from pharmacogenomic (PGx) testing based on Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines. (2) Methods: EMR data from a clinical research data warehouse were analyzed from 845,518 patients that had an encounter between 2015 and 2019 at an academic medical center. Data were collected for 42 commercially available drugs with 52 evidence-based PGx guidelines from CPIC. Provider data were obtained through the EMR linked by specialty via national provider identification (NPI) number. (3) Results: A total of 845,518 patients had an encounter in the extraction period with 590,526 medication orders processed. A total of 335,849 (56.9%) patients had medication orders represented by CPIC drugs prescribed by 2803 providers, representing 239 distinct medications. (4) Conclusions: The results from this study show that over half of patients were prescribed a CPIC actionable medication from a variety of prescriber specialties. Understanding the magnitude of patients that may benefit from PGx testing, will enable the development of preemptive testing processes, physician support strategies, and pharmacist workflows to optimize outcomes should a PGx service be implemented.

Optimalisasi Legalitas UMKM Perempuan melalui Program Peningkatan Kapasitas UMKM CSR Bank SUMUT di Kota Medan

Micro, Small, and Medium Enterprises (MSMEs) play a key role in the present-day economy of the nation. One aspect of enhancing the capabilities of micro, small, and medium enterprises (UMKM) is ensuring their compliance with regulatory requirements. The first phase involved the legal registration of the NIB (National Identification Number for Businesses) to facilitate the professional monitoring of commercial competitiveness for micro, small, and medium enterprises (UMKM). In accordance with the significance of enhancing the capacity of micro, small, and medium enterprises (UMKM) in the City of Medan, CSR Bank SUMUT, in collaboration with academic professionals from Krisnadwipayana Univeristy, has initiated a program aimed at providing assistance, socialization, and support for the establishment of NIB. This program forms part of the Women's UMKM Capacity Enhancement Program, which is being implemented in the city of Medan. Through socialization and direct guidance to Women SMEs in Medan, it has contributed to an enhanced comprehension among them about the importance legal aspects of their businesses.&#x0D;

Lower incidence of new-onset heart disease following covid-19 compared to viral pneumonia despite more echocardiography

Abstract Background Studies have shown an increased risk of cardiac disease and dysfunction following COVID-19. However, it remains unknown whether infection with COVID-19 differs from other viral pneumonias with respect to subsequent incident heart disease. Purpose To determine the incidence of heart disease and use of cardiac procedures in patients following a diagnosis of COVID-19 compared to other viral pneumonias. Methods In a retrospective, observational study, we compared incidence rates for cardiac disease diagnosed after hospitalization with COVID-19 February-November 2020 versus hospitalization with viral pneumonia as the main diagnosis in 2018-2019. Data was obtained from The Norwegian Patient Registry and the Norwegian Surveillance System for Communicable Diseases, and linked with a unique national person identification number. We defined heart disease using ICD-10 codes and used Cox regression models to compare the hazard of first episodes of myocarditis, acute myocardial infarction, atrial fibrillation/flutter, heart failure, ischemic disease, other cardiac disease, and total heart disease (any of these conditions). Patients were followed until 31 December 2020, with censoring on this date or a maximum of 274 days after hospital admission. Results Patients hospitalized with COVID-19 in 2020 (n = 2,359) were younger, mean 59 (SD 18) vs 69 (19) years, had fewer comorbidities, had fewer hospitalizations prior to the index hospitalization (0.5 (1.2) vs 0.9 (1.8)), were more frequently treated with respiratory support (14.2% vs 7.8%) and had higher in-hospital mortality (6.9% vs 2.3%) than patients hospitalized with viral pneumonia in 2018-2019 (n = 9,018). Patients hospitalized with COVID-19 had a lower crude incidence of new total heart disease than those with viral pneumonia (56 [95%CI 48-65] vs 75 [95%CI 71-79] per 100,000 person-years). This difference persisted after adjusting for age, sex, Charlson comorbidity score (comprising age, sex, and 17 dichotomized comorbidities), hospital admission during the previous year, respiratory support, and a propensity score for being hospitalized for COVID-19 vs. other pneumonia: Hazard ratio (HR) 0.79 [95%CI 0.67-0.94], p = 0.006. Patients with COVID-19 more frequently underwent echocardiography: HR 1.41 [1.23-1.63], p = &amp;lt;0.001 (Fig. 1). Conclusion Following hospitalization for COVID-19, the incidence of total heart disease and heart failure was lower than for patients hospitalized with viral pneumonia, despite more frequent examinations with echocardiography.Figure 1

Strengthening the Security and Privacy of National Identity Numbers (NINs) in Smart Contract Mechanisms through AES Encryption

Strengthening the Security and Privacy of National Identity Numbers (NINs) in Smart Contract Mechanisms through AES Encryption

Prevention of Childhood Adversities and Children’s Common Mental Disorders and School Grades

Adversity during childhood can limit children's chances of achieving their optimal developmental and psychological outcomes. Well-designed observational studies might help identify adversities that are most implicated in this, thereby helping to identify potential targets for developing interventions. To compare the association between preventing childhood poverty, parental mental illness and parental separation, and the population rate of offspring common mental disorders (ages 16-21 years) or average school grades (age 16 years). A population-based, longitudinal cohort study using Swedish registries was conducted. A total of 163 529 children born in Sweden between January 1, 1996, and December 31, 1997, were followed up until their 21st birthday. They were linked to registries using Sweden's national personal identification number. Children were linked to birth parents, hospital records, and school data. Parents were linked to registries containing health, income, sociodemographic, and obstetric data. Analyses were conducted between January 10, 2021, and August 26, 2022. Childhood adversities of relative poverty (household disposable income <50% of the median), parental inpatient admission for a mental illness, or parental separation. Adversities were categorized into developmental periods: ages 0 to 3, 4 to 7, 8 to 11, and 12 to 16 years. The main outcomes were children's hospital records with a diagnosis of anxiety or depression between ages 16 and 21 years and school grades at the end of compulsory education (age 16 years). The parametric g-formula modeled population changes in outcomes associated with the counterfactual, hypothetical preventing adversity exposures, accounting for fixed and time-varying confounders. Adjustments were made for parental demographic characteristics, obstetric variables, and socioeconomic data at birth. A total of 163 529 children were included in the cohort (51.2% boys, 51.4% born in 1996). Preventing all adversities was associated with an estimated change in the prevalence of offspring common mental disorders from 10.2% to 7.6% and an improvement in school grades with an SD of 0.149 (95% CI, 0.147-0.149). Preventing parental separation provided for the greatest improvement, with an estimated 2.34% (95% CI, 2.23%-2.42%) fewer children with a common mental disorder and an improvement in school grades by 0.127 SDs (0.125-0.129). Greater improvements were shown by hypothetically targeting adolescents (age 12-16 years) and those whose parents had a mental illness when the child was born. The results of this cohort modeling study suggest that preventing childhood adversity could provide notable improvements in the rates of common mental disorders and school grades. Many children might achieve better life outcomes if resources are properly allocated to the right adversities (parental separation), the right groups (children with parental mental illness), and at the right time (adolescence).

Farmer card as an instrument for fertilizer direct subsidy on Lombok Island, Indonesia

Like other direct subsidies using subsidy cards, direct fertilizer subsidies using farmer cards are believed to be a mechanism for providing subsidies that are more appropriate for target farmers. However, before this policy is widely implemented, it is necessary to carry out a trial phase for its implementation. The trial was carried out in Sekarbela District, Mataram City with the consideration of the availability of relatively complete data on subsidy recipient farmers accompanied by a National Identity Number (NIK). The trial results indicated that the farmers receiving the subsidy were generally young (48-50 years old), had more than 20 years of farming experience, and most of them controlled land of less than 0.5 hectares with ownership, lease or cultivation status. However, most of the farmers (88%) have only elementary school education but are active in preparing the Group Needs Definitive Plan (RDKK). The results of the analysis conclude that the probability of using a Farmer’s Card to obtain subsidized fertilizer is smaller for tenant farmers compared to owning or cultivating farmers. In addition, farmers with a higher level of education have a greater probability of using the farmer’s card as a means of obtaining subsidized fertilizer.