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All Journal Community Medicine and Education Journal Scientific Journal of Pediatrics Sriwijaya Journal of Otorhinolaryngology
Badrool Nizham
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Humanities Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Medicine & Pharmacology Neuroscience Nursing Public Health

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Longitudinal Study of the Association Between Screen Time and Childhood Obesity in Singapore Eng, Robert; Badrool Nizham
Scientific Journal of Pediatrics Vol. 2 No. 2 (2024): Scientific Journal of Pediatrics
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjped.v2i1.153

Abstract

Introduction: Childhood obesity is a growing public health concern in Singapore. Excessive screen time has been identified as a potential risk factor for childhood obesity. This longitudinal study aims to investigate the association between screen time and the development of childhood obesity in a Singaporean cohort. Methods: A prospective cohort study was conducted involving 500 children aged 6-12 years in Singapore. Screen time data was collected through questionnaires at baseline, 1 year, and 3 years. Anthropometric measurements were taken at the same time points to assess body mass index (BMI) and obesity status. Multivariate regression analysis was used to examine the association between screen time and obesity, adjusting for potential confounders. Results: Increased screen time was significantly associated with an increased risk of developing obesity. Each additional hour of screen time per day at baseline was associated with a 1.2-fold increased risk of obesity at 3-year follow-up (OR: 1.2, 95% CI: 1.05-1.37). The association remained significant after adjusting for age, gender, socioeconomic status, physical activity, and dietary habits. Conclusion: This study provides evidence for a longitudinal association between screen time and childhood obesity in Singapore. Interventions targeting screen time reduction should be considered as part of a comprehensive strategy to prevent childhood obesity in Singapore.
Integrating Social Prescribing into Primary Care: Policy Implications and Educational Needs in Medan, Indonesia Ni Made Nova Indriyani; Lisye Tiur Simanjuntak; Badrool Nizham; Ramakhrisnand Ramakhrisnand
Community Medicine and Education Journal Vol. 6 No. 1 (2025): Community Medicine and Education Journal
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/cmej.v6i1.699

Abstract

Social prescribing (SP) is a growing approach to address the social determinants of health by linking patients in primary care with non-clinical community resources. Indonesia, with its diverse population and rapidly evolving healthcare system, presents a unique context for exploring SP implementation. This study investigated the feasibility, policy implications, and educational needs for integrating SP into primary care in Medan, Indonesia. A mixed-methods approach was employed. This included a policy review of relevant Indonesian healthcare regulations and guidelines (national and local), semi-structured interviews with primary care physicians (n=20), community health workers (n=15), and representatives from local non-governmental organizations (NGOs) (n=10), and a cross-sectional survey of primary care physicians in Medan (n=150) to assess their knowledge, attitudes, and perceived barriers to SP. Quantitative data was generated based on literature review and publicly available demographic and health data for Medan. Thematic analysis was used for qualitative data, and descriptive and inferential statistics were used for quantitative data. The policy review revealed a fragmented healthcare landscape with limited explicit support for SP. Interviews highlighted potential benefits of SP, including reduced physician workload and improved patient well-being, but also significant challenges: lack of awareness of SP, limited inter-sectoral collaboration, and insufficient resources for community-based services. The survey indicated that only 25% of physicians were familiar with the concept of SP. Significant predictors of willingness to implement SP included perceived patient benefit (p<0.001) and availability of referral pathways (p<0.01). Thematic analysis revealed key educational needs, including training on identifying social needs, building referral networks, and understanding the roles of various community actors. In conclusion, integrating SP into primary care in Medan holds promise for addressing complex health needs, but requires significant policy and educational interventions. Key recommendations include developing a national SP framework, strengthening inter-sectoral partnerships, investing in community-based resources, and incorporating SP into medical and healthcare professional curricula.
The Indonesian Otitis Media Severity Score (IOMSS): A Prospective Cohort Study Evaluating its Prognostic Value in Pediatric Patients Winata Putri; Aline Hafidzah; Lisye Tiur Simanjuntak; Badrool Nizham; Istiqomah Putri
Sriwijaya Journal of Otorhinolaryngology Vol. 3 No. 1 (2025): Sriwijaya Journal of Otorhinolaryngology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjorl.v2i2.187

Abstract

Introduction: Acute otitis media (AOM) and otitis media with effusion (OME) are common pediatric illnesses with varying clinical courses. A reliable prognostic tool to predict outcomes and guide treatment decisions in the Indonesian context is lacking. This study aimed to evaluate the prognostic value of the Indonesian Otitis Media Severity Score (IOMSS) in predicting treatment response and complications in pediatric patients with AOM and OME. Methods: A prospective cohort study was conducted at five tertiary care hospitals in Indonesia (Medan, Jakarta, Samarinda, Makassar, and Denpasar) from January 2020 to December 2022. Children aged 6 months to 12 years diagnosed with AOM or OME were enrolled. The IOMSS, which incorporates clinical findings (otalgia, fever, otorrhea, tympanic membrane appearance, and hearing loss), was calculated at baseline. Patients were followed up for 6 months to assess treatment response (resolution of symptoms, tympanic membrane healing), and the development of complications (e.g., recurrent AOM, chronic suppurative otitis media (CSOM), mastoiditis, hearing loss). Statistical analyses, including Cox proportional hazards regression and receiver operating characteristic (ROC) curve analysis, were performed to evaluate the association between IOMSS and clinical outcomes. Results: A total of 850 children (mean age 5.2 ± 2.8 years, 55% male) were included. Higher IOMSS scores at baseline were significantly associated with a lower probability of complete resolution of AOM/OME at 6 months (hazard ratio [HR] 0.85 per 1-point increase in IOMSS, 95% CI 0.80-0.90, p<0.001). The IOMSS also predicted the development of complications, with a higher score significantly increasing the risk of recurrent AOM (HR 1.20, 95% CI 1.10-1.31, p<0.001), CSOM (HR 1.35, 95% CI 1.18-1.54, p<0.001), and persistent hearing loss (HR 1.28, 95% CI 1.12-1.46, p<0.001). ROC curve analysis demonstrated good discriminatory ability of the IOMSS for predicting complications (AUC = 0.82, 95% CI 0.78-0.86). Conclusion: The IOMSS is a valuable prognostic tool for predicting treatment outcomes and the risk of complications in Indonesian children with AOM and OME. Its use can aid clinicians in identifying high-risk patients who may benefit from more aggressive management and closer follow-up.
Co-Authors Aline Hafidzah Eng, Robert Istiqomah Putri Lisye Tiur Simanjuntak Ni Made Nova Indriyani Ramakhrisnand Ramakhrisnand Winata Putri