bluuebunny/crossref_metadata_2025 huggingface dataset:
1503The association of work-related stress with aggravation of pre-existing disease during COVID-19 emergency in Japan
Authors: He Yupeng , Yatsuya Hiroshi , Chiang Chifa , Ota Atsuhiko , Okubo Ryo , Ishimaru Tomohiro , Tabuchi Takahiro
Published: September 2021

Background

The job environment has changed since the sweeping of coronavirus disease 2019 (COVID-19) pandemic. The current study aimed to investigate the association between work-related stress and aggravation of pre-existing disease among workers during the first state of COVID-19 emergency in Japan.

Methods

Data were obtained from Japan COVID-19 and Society Internet Survey (JACSIS) conducted between August 25 and September 30, 2020. Participants who reported had a job as well as current history of disease(s) (i.e., pre-existing conditions) were included (n = 3090). Work-related stress since the state of COVID-19 emergency (April 2020) was assessed according to the job demand-control model. Aggravation of pre-existing disease during the state of emergency was self-reported. Multivariable logistic regression models were adopted to demonstrate the association.

Results

334 (11%) participants reported with aggravation of pre-existing diseases. The numbers of participants with high demand and low control were 112 (18%) and 100 (14%), respectively. Compared to medium demand, high demand was significantly associated with aggravation of pre-existing diseases (odds ratio: 1.67, 95% confidence interval: 1.20-2.28). Low control was significantly associated with aggravation of pre-existing diseases (odds ratio: 1.41, 95% confidence interval: 1.02-1.95) compared to medium control.

Conclusions

Work-related stress during the first state of COVID-19 emergency was associated with aggravation of pre-existing disease during that period.

Key messages

Eleven percent of the working participants with pre-existing diseases reported its aggravation during the first state of COVID-19 emergency in Japan.

Job strain characterized by high job demand and low job control was associated with aggravation of pre-existing disease.
215Impact of Brazilian Family Health Strategy on Reproductive Health: Analysis at Individual and Population Levels
Authors: Hellwig Franciele , Parfitt Rafael , Weber Gabriel
Published: September 2021

Background

Family Health Strategy (FHS) is the largest community-based health program in Brazil. There is limited evidence about its effectiveness, especially about adolescents. We aimed to access its effects on adolescents’ reproductive health.

Methods

We estimate its effects on contraception at individual level using data from a national health survey carried out in 2013 and applying propensity score matching combined with complex survey weights. We employed a differences-in-differences approach for evaluate its effects on adolescent maternity rate at municipal level between 1996 and 2016.

Results

FHS has positive effects on the probability of using contraceptives. The highest effect was over the concomitant use of pills and male condom (increase of 12 percentage points). For households with female adolescents, it was even higher (26 percentage points). We found a monotonous decrease on adolescent maternity rate following exposure time to FHS, especially in the poorest regions.

Conclusions

Even not being focused on reproductive health, FHS has positive effects on it. We interpret the negative impact on adolescent maternity rates to be linked to an increased use of contraceptive methods.

Key messages

Programs such as FHS can be extremely important in promoting knowledge about family planning, especially for adolescents living in social vulnerability. We believe our findings to be important inputs for the discussion in countries where early childbearing is more prevalent, and inequalities are particularly striking..
1439Hepatitis B prevalence in the Indian Subcontinent: a systematic review and meta-analysis
Authors: Hogan Sam , McBride Kate , Page Andrew , Dixit Sameer
Published: September 2021

Background

Hepatitis B virus (HBV) infections are a major global health burden. Although a vaccine exists for HBV, some developing nations still struggle to reduce prevalence. While the countries within the Indian Subcontinent have vaccination programs, HBV prevalence varies. It is important to identify population groups at risk.

Methods

Several databases were systematically searched for papers appropriate studies. Studies were included if the sample population lived within one of the selected countries and had no other existing health issues. The studies were assessed for risk of bias, and pooled estimates were created. Subgroups which were assessed included countries, sex, rural and urban populations.

Results

The pooled prevalence of all studies (N = 56) was 4%. For the countries with multiple included studies, the prevalence for India, Pakistan, Bangladesh and Nepal were calculated as 3%, 6%, 5% and 1% respectively. Most of the studies were assessed as being of reasonable quality. There was a chance that publication bias was present.

Conclusions

While some of the populations had the expected prevalence for the country in which the study was set, other subpopulations had higher prevalence. The highest HBV prevalence was found in displaced persons and those engaging in risk taking behaviours, however some high prevalence groups did not have a clear reason.

Key messages

Although HBV prevalence in general is lower at present than in the past, there are still at-risk groups with higher prevalence than the general population.
397A Meta-Analysis of Randomized Clinical Trials on Calcium Intake for Obesity Indices
Authors: Hong Jee Yeon , Lee Ji Seon , Woo Hye Won , Om Ae Son , Kim Mi Kyung
Published: September 2021

Background

There was no consistent finding of changes of obesity indices including fat mass by calcium supplements and dairy products intervention. Therefore, we conducted the meta-analysis of evidence on calcium supplements and dairy products (≥ 12 weeks) on changes in the obesity index (fat mass, as well as weight, body mass index, waist circumference) from randomized controlled trials (RCTs).

Methods

We searched for original articles during the last 10 years until August 19, 2019, using PubMed and EMBASE. The extracted data were analysed with random effects, inverse variance model using Review Manager 5.3 ver.

Results

Finally, ten RCTs with calcium supplements and fourteen RCTs with dairy products among adults aged 18 years old or over were selected. The intervention with calcium supplements showed significant change of fat mass (SMD, 95% CI; -0.21 [-0.37, -0.04], p = 0.02), but not in changes in body weight (p = 0.45), BMI (p = 0.14) and WC (p = 0.88). Dairy products also showed significant results in changes of fat mass (SMD, 95% CI; -0.51 [-0.90, -0.11], p = 0.01) as well as BMI (WMD, 95% CI; -0.46 [-0.67, -0.26], p < 0.00001), but not in changes of body weight (p = 0.70) and WC (p = 0.27).

Conclusions

The fat mass may be reduced by both calcium supplements and dairy products intervention over 12 weeks among adults 18 years old or over. Dairy products may be beneficial for BMI reduction.

Key messages

Dietary calcium intake might reduce fat mass in adults (≥ 18 years).
1001Spatio-temporal epidemiology of mumps and related region factors in Korea
Authors: Hong Kwan , Hwang Hari , Chun Byung Chul
Published: September 2021

Background

Mumps is in Korea's national immunization program, though there are still epidemics, especially in young age. The study's objectives are to establish the epidemiological characteristics of mumps and suggest the predicting factors.

Methods

We extracted cases from national health insurance data, between 2013 and 2017. Age-specific incidence rate and geographical distribution were evaluated. We tested for spatial autocorrelation by Moran’s I statistics with Delaunary triangular links. Simultaneous autoregressive model for cumulative incidence of mumps using triangular links was used to predict cumulative incidence with region specific factors.

Results

A total of 219,149 (85.12 per 100,000) were diagnosed and 23,805 (9.25 per 100,000) were hospitalized. Weekly cumulative incidence showed two epidemics every year, between weeks 20-25 and 40-45. Cumulative incidence of ages 10-19 was the highest, 332.21 per 100,000 people, followed by 300.75 per 100,000 people in ages 0-9. Geographical distribution showed clusters of epidemics, and Moran’s I statistics was 0.304 with a p-value <0.01. The Simultaneous autoregressive model estimated the mean age and hospital resources of each region as prediction factors for geographical distribution of mumps.

Conclusions

Mumps is common in children and peaks in summer and winter. Additionally, there are geographical clusters in epidemics, and the effect of region factors such as mean age and hospital resources are suspected.

Key messages

Two peaks in age and season appear in mumps in Korea. Clusters of geographical distribution indicate that region factors may affect the incidence.
200Pneumonia hospitalization and the subsequent risk of incident ischemic cardiovascular disease in Chinese adults
Authors: Hu Yizhen , Yu Canqing , Guo Yu , Bian Zheng , Han Yuting , Yang Ling , Chen Yiping , Du Huaidong , Sun Dianjianyi , Chen Junshi , Chen Zhengming , Lv Jun , Li Liming
Published: September 2021

Background

Acute respiratory infections have been associated with a transient increase in cardiovascular risk. However, whether such an association persists beyond one month, and the potential modifying effect of cardiovascular risk factors on such an association is less well established.

Methods

The China Kadoorie Biobank study enrolled 512,726 participants from 10 areas across China during 2004-08. By the end of 2017, a total of 5,444 participants with ischemic heart disease (IHD) and 4,846 with ischemic stroke (IS) who also had at least a record of hospitalization for pneumonia during follow-up were included. We used a self-controlled case series method and calculated the age- and season-adjusted relative incidences (RIs) and 95% confidence intervals (CIs) for ischemic cardiovascular disease (CVD) after pneumonia.

Results

The risk of ischemic CVD increased during days 1-3 after pneumonia hospitalization, with a RI (95% CI) of 4.24 (2.92-6.15) for IHD and 1.85 (1.02-3.35) for IS. The risk gradually reduced with longer duration since pneumonia hospitalization but remained elevated until days 92-365 for IHD (1.23, 1.12-1.35), and days 29-91 for IS (1.25, 1.05-1.48). Pre-existing cardiovascular risk factors amplified the associations between pneumonia and ischemic CVD risks. Besides, the risk of ischemic CVD was also higher among the participants aged ≥70 years (Pinteraction<0.001 for IHD and =0.033 for IS).

Conclusions

Among middle-aged and older Chinese adults, pneumonia hospitalization was associated with both short- and long-term increases in ischemic CVD risk for up to one year.

Key messages

Pneumonia hospitalizations were associated with increased subsequent risk of ischemic CVD.
550Short-term exposure to grass pollen is associated with lower lung function and increased airway inflammation
Authors: Sabrina Idrose N. , Tham Rachel , Lodge Caroline , Lowe Adrian , Bui Dinh , Perret Jennifer , Vicendese Don , Newbigin Ed , Tang Mimi , Aldakheel Fahad , Douglass Jo , Abramson Michael , Walters Haydn , Erbas Bircan , Dharmage Shyamali
Published: September 2021

Background

The association between grass pollen exposure and lung function changes and airway inflammation is limited. We investigated these associations in a community-based sample, and whether any such associations were modified by current asthma, current hay fever, pollen sensitization and age.

Methods

Cross-sectional analyses of data from the Melbourne Atopy Cohort Study (MACS) participants (n = 936). Lung function was assessed using spirometry. Airway inflammation was assessed by fractional exhaled nitric oxide (FeNO), and exhaled breath condensate pH and nitrogen oxides (NOx). Daily pollen counts were collected using a volumetric spore trap. The associations were examined by linear regression.

Results

Higher ambient levels of grass pollen 2 days before (lag 2) were associated with lower mid-forced expiratory flow (FEF25-75%) and FEV1/FVC ratio (Coef. [95% CI] = -119 [-226, -11] mL/s and -1.0 [-3.0, -0.03] %, respectively) and also 3 days before (lag 3). Increased levels of grass pollen a day before (lag 1) was associated with increased FeNO (4.35 [-0.1, 8.7] ppb) and also at lag 2. Adverse associations between pollen and multiple outcomes were greater in adults with current asthma, hay fever and pollen sensitization.

Conclusions

Grass pollen exposure was associated with eosinophilic airway inflammation 1-2 days after exposure and airway obstruction 2-3 days after exposure.

Key messages

There is a more delayed effect on lung function compared to airway inflammation. Adults with current asthma, hay fever and grass pollen sensitisation are especially vulnerable.
1249Trends and disparities in adult body mass index across 47 prefectures in Japan, 1975–2018
Authors: Ikeda Nayu , Nakaya Tomoki , Bennett James , Ezzati Majid , Nishi Nobuo
Published: September 2021

Background

Consistent and comparable health information across prefectures is necessary for monitoring progress in improving population health and reducing geographic health disparities in Japan. We aimed to examine long-term trends and variations in adult body mass index (BMI) by prefecture.

Methods

We obtained a total sample of 233,988 males and 261,086 females aged 20–79 years with anthropometric measurements from National Health and Nutrition Surveys conducted annually during 1975–2018. We applied a spatio-temporal Bayesian hierarchical model to estimate the annual time series of prefectural mean BMI by 20-year age group and sex.

Results

Prefectural mean BMI consistently increased in males regardless of age but decreased in younger females. It increased in older females until starting to decrease in the early 2000s. Mean BMI was noticeably higher in Okinawa, the southernmost prefecture, than in other prefectures from 1975 in males and from the 1990s in females. The interquartile range of mean BMI across prefectures was consistently higher in females than in males. It decreased over time to plateau during the 2000s in both sexes.

Conclusions

Mean BMI increased in males across prefectures and there is a need for stimulating a further reduction in geographic disparities particularly for females. Okinawa once ranked first in longevity but has shown relatively poor performance in recent years, which may be partly attributable to the distinctive trends in adult BMI.

Key messages

Bayesian hierarchical modelling is useful for reconstructing long-term spatio-temporal trends of mean BMI by integrating small-size survey samples.
1045Patterns, predictors and outcomes of opioid use in Australia: evidence for an epidemic?
Authors: Ilomaki Jenni , Lalic Samanta , Gisev Natasa , Nielsen Suzanne
Published: September 2021

Focus and outcomes for participants

This symposium will focus on evidence from pharmacoepidemiological research on prevalence and incidence of prescription opioid prevalence, opioid utilisation patterns and related harms in Australia. The symposium will also discuss interventions to reduce opioid-related harm. The speakers will discuss how opioid use and prescribing culture has evolved over the last two decades and provide insight from recent research using big data analysis on prescription opioid use and related outcomes.

Rationale for the symposium, including for its inclusion in the Congress

In 2016, there were 679 overdose deaths involving opioid pain medications in Australia, with the majority of these deaths unintentional. There is growing concern that harm from opioid pain medications in Australia may mimic the situation in the United States and Canada, where the problem has been labelled an epidemic.

Recent Monash led research using Australia’s Pharmaceutical Benefits Scheme data for 2013 to 2018 found that approximately 3 million Australians adults use opioids each year and approximately 1.9 million adults start taking opioids. Of this population of adults that start using opioids, 2.6% become long-term users for over a year. Long-term use and the use of strong opioids are associated with a range of adverse health outcomes. High-dose opioid use has also been associated with falls, fractures, hospitalisations and motor vehicle injuries.

The rationale of this symposium is to draw on the expertise of the presenters and share innovative epidemiological and data analysis methods to understand opioid use in the Australian context. The creation of such a forum at the World Congress will allow for enhanced knowledge sharing on both a national and international platform and assist in planning strategies to better anticipate and manage potential harms when opioid pain medications are initiated.

Presentation program

The Symposium consists of four presentations:

Names of presenters

Names of facilitator or chair

Professor Danny Liew, Deputy Head of School, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia

Ms. Michelle Steeper, Research Officer, Centre for Medicine Use and Safety, Monash University, Melbourne, Australia
1372Food-network Analysis: The impact of change in food intake on other foods and energy intake
Authors: Iqbal Khalid , Walter Antonia , Schwingshackl Lukas , Schwedhelm Carolina , Knüppel Sven , Boeing Heiner
Published: September 2021

Background

Intake of most foods show correlations with other foods implying that change in the intake of one food affects the intake of other foods. However, it is unclear whether such relationships are quantitatively meaningful and should be considered when a change in dietary intake is suggested.

Methods

We used data from European Prospective Investigation into Cancer and Nutrition-Potsdam and the previously published pairwise partial correlations between 49 food groups and calculated the impact of modifications in three correlated food groups that are relevant for public health, i.e. whole grain bread, white bread and processed meat, on intakes of other foods and total energy.

Results

Increase in the quantities of whole grain bread by 25% resulted in lowered white bread quantities both in men (7%) and women (8%). A 25% decrease in quantity of white bread resulted in increased quantities of whole grain bread (10-11%) and decreased (6%) in processed meat. Lowering intake of processed meat by 25% resulted in lower intakes of refined bread in both sexes. A simultaneous increase of whole grain bread and decrease in white bread and processed meat amplified the desirable benefit by increasing intake of whole grain bread by 12 g in men and 16 g in women. Simultaneous modification of all three food groups resulted in an overall decrease of 212 Kcal in men and 121 Kcal in women.

Conclusions

In conclusion, this study could show that the interdependencies between the intakes of foods affect not only the implicated food of an intended change but the whole diet including energy intake.

Key messages

Food networks has the potential to identify optimum changes required to achieve desired modification in dietary intake.
486Serum levels of miRNA-221 and -222 may be predictive biomarkers for cognitive decline
Authors: Ishihara Yuya , Yamada Hiroya , Munetuna Eiji , Hagiwara Chiharu , Fujii Ryosuke , Yamazaki Mirai , Hatta Takeshi , Iwahara Akihiko , Ohashi Koji , Ishikawa Hiroaki , Ando Yoshitaka , Mizuno Genki , Tuboi Yoshiki , Suzuki Koji
Published: September 2021

Background

Although dementia is a huge problem in public health, no fundamental biomarker has been established to detect cognitive decline at the early stage. MicroRNAs (miRNAs) regulate gene expression, and are associated with the development of various diseases.

Methods

The subjects of this prospective study were 162 (75 men, 87 women) residents who attended a health examination in Yakumo town in Hokkaido, in 2012 and re-attended at least once while 2013 to 2015. Serum samples were collected in 2012 and serum miRNA were measured by qRT-PCR. We used a short version of the Mini-Mental State Examination (SMMSE) to screen cognitive function, and calculated the change in SMMSE score per year. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) of serum miRNA levels for cognitive decline (decrease of greater than 0.5 points per year) using the lowest tertile group of miRNAs as the reference by logistic regression analysis.

Results

The mean age and change in SMMSE score of the subjects was 63.9±9.6 years and -0.03±1.19 points. Odds ratios (ORs) for cognitive decline were significantly higher in the highest tertile of serum miR-221 (OR = 3.24, 95%CI=1.20-8.72) and miR-222 (OR = 4.01, 95%CI=1.36-11.80) even if confounding factors were adjusted.

Conclusions

High serum levels of miR-221 and -222 were significantly associated with cognitive decline.

Key messages

High serum levels of miR-221 and -222 may be potential candidate biomarkers for prediction of cognitive decline.
1508Comparison of two waves of the COVID-19 pandemic in Rural Bikaner: A record based analysis
Authors: Joshi Doctor Shree Mohan , Acharya Doctor Rekha , Meena Doctor Rati Ram
Published: September 2021

Background

In comparison to the slow progression of first wave of the COVID-19 pandemic, by March 2021, the second wave appeared to be much more aggressive with many more cases. We aimed to evaluate reported COVID-19 epidemiology data to better understand the pandemic's progression in Rural Bikaner.

Methods

A record-based descriptive analysis study between first and second covid-19 waves, on the variables of interest including positivity rates, case fatality rate, demographic profile of positive patients.

Results

the daily reported cases at the peak of the first wave in rural area in 2020 was 20-25 cases per day and in second wave number of cases was increased double to first wave. Death rate and severity was also increased in second wave. In second wave the mean age of positive patients was decreased.

Conclusions

In our analysis rural area had a more severe second wave of the COVID-19 pandemic than the first and highlights the importance of examining multiple epidemiological variables down to the regional and country levels over time. These country-specific and regional results informed the implementation of continent-wide initiatives and supported equitable distribution of supplies and technical assistance. Monitoring and analysis of these data over time are essential for continued situational awareness, especially as Member States attempt to balance controlling COVID-19 transmission with ensuring stable economies and livelihoods.

Key messages

Demographic profile of rural area plays a key role in spread of Covid-19 cases.
850Description of total population hospital admissions for Craniosynostosis in Australia
Authors: Junaid Mohammed , Slack-Smith Linda , Leonard Helen , Wong Kingsley
Published: September 2021

Background

Craniosysnostosis (CS) is a condition ensuing from premature fusion of cranial sutures, resulting in altered craniofacial morphology, requiring early neurosurgical interventions to improve prognosis and outcomes. This study aimed to describe total population hospital admissions related to craniosynostosis in Australia over a 22-year period.

Methods

Population summary data for admissions to public and private hospitals were obtained from the Australian Institute of Health and Welfare National Hospital Morbidity Database (July 1996 to June 2018). The primary outcome variable was a hospital separation with the principal diagnosis of craniosynostosis, craniodysostosis or acrocephalosyndactyly (ICD9CM diagnosis codes 756.00 and 756.01 between July 1996– June 1998 and ICD10AM diagnosis codes Q75.0, Q75.1 and Q87.02 for July 1998 onwards). Trends in rates of hospital admission and length of stay by age, gender and type of craniosynostosis were investigated by negative binomial regression.

Results

A total of 8,115 admissions were identified between July 1996 to June 2018. Marginal decrease in hospital admission rates [-0.02 (95%CI 0.03, 0.001)] has been observed over a duration of 22 years. Admissions were higher for males, infants (<1 year) and nonsyndromic cases of disease. Average length of stay at hospitals for CS was calculated to be 5.3 ± 1.3 days per year which were even lengthier with syndromic conditions.

Conclusion

This study has identified population level trends in hospital separation for craniosynostosis in Australia.

Key Message

Population administrative data, despite limitations provides useful information to inform research and practice.
1113Depressive symptoms and objectively measured physical activity and sedentary behaviour in adolescents
Authors: Kandola Aaron
Published: September 2021

Background

Physical activity and sedentary behaviour could be crucial risk factors for adolescent depression. This is the first study to use objective physical activity and sedentary behaviour measure to examine their association with depression in adolescents.

Methods

We analysed accelerometer data from population-based adolescents at ages 12, 14, and 16 and depressive symptoms at age 18. We used negative binomial regression and group-based trajectory models to analyse the data.

Results

We found that total physical activity decreased between 12 years and 16 years of age, driven by a decline in light activity and increase in sedentary behaviour. Each additional 60-minute increase in daily sedentary behaviour at ages 12, 14, and 16 was associated with an increased depression score at age 18 of 11·1% (95% CI, 5·1, 17·6), 8% (95% CI, 1·2, 15·2), and 10·5% (95% CI, 1·5, 20·8), respectively. Depression scores at age 18 were 9·6% (95% CI, 3·9, 15), 7.8% (95% CI, 0·8, 14.3), and 11·1% (95% CI, 2·6, 19.1) lower per additional 60-minutes of daily light activity time at ages 12, 14, and 16. These findings were robust to a series of sensitivity analyses.

Conclusions

Sedentary behaviour displaces light activity throughout adolescence and is associated with a higher risk of depressive symptoms at 18 years of age.

Key messages

Increasing light activity and decreasing sedentary behaviour during adolescence could be an important target for public health interventions aimed at reducing the prevalence of depression.
1490Activist and Epidemiologist: Collision or Synergy?
Authors: Kavanagh Anne
Published: September 2021

Focus of Presentation

In this presentation, I discuss how activism and lived experience can enhance epidemiological research. I argue that my lived experience of disability and activism, enhance my research because I: have understanding of the contexts in which disabled people live, I focus on what is relevant to disabled people, and have the impetus to interrogate government knowledge claims. I illustrate this through two research/activism scenarios: COVID-19 pandemic proposed reforms to Australia’s National Disability Insurance Scheme (NDIS) – which provides individual budgets for nearly 500,000 Australians with disability.

Findings

During the COVID-19, I spearheaded ‘calls to action’ for governments to respond to the specific risks faced by people with disability. I led a research demonstrating the risks to disability support workers. My expert witness testimonies at the Disability Royal Commission were central to the Commission’s recommendations. And my work changed government policies relating to managing outbreaks in disability settings and vaccination. In relation to the NDIS, I have critiqued the research government conducts, and the data they use, to support their arguments for reform.

Conclusions/Implications

Being an activist with lived experience requires reflexivity to ensure individual biases are not reinforced, but it also offers opportunities. Research is contextualised and the pathway to change more easily charted. Epidemiology should foster the careers of researchers with lived experience who maybe activists as well.

Key messages

Lived experience researchers and activists can enhance epidemiological research bringing unique insights and new opportunities for change.
517Challenges in data linkage – experiences from an upper gastrointestinal cancer data linkage study
Authors: Khan Nadia , Ioannou Liane , Pilgrim Charles , Earnest Arul , Maharaj Ashika , Croagh Daniel , Liew Danny , Atwood David , Holland Jennifer , Philip Jennifer , Emery Jon , Ijzerman Maarten , Brown Wendy , Zalcberg John , Evans Sue
Published: September 2021

Background

Linked, population-level data is valuable for mapping patterns of care and evaluating health service utilisation, particularly in difficult-to-reach populations. Upper gastrointestinal (UGI) cancers have a dismal prognosis, creating difficulties engaging patients in research. The utility of a linked dataset in this population is of high value.

Methods

Key objectives included identifying the operational and feasibility issues associated with linking Australian state-based administrative and registry data for understanding health service utilisation in UGI cancers. Datasets pertained to hospital admissions, radiotherapy, community health, primary care, palliative care, Medicare and Pharmaceutical Benefits Schedule’s and UGI cancers.

Results

From a logistical perspective, data access request approval processes varied, with some requiring consent to be sought from individual services contributing data. The availability of unique person-level identifying information varied widely. Additionally, the time period of data capture differed between and within datasets, limiting the quality of the linked data. Significant costs were associated with linking with primary care and Medicare and Pharmaceutical Benefits Schedule’s. Federal dataset linkage required at least a one-year waiting period.

Conclusions

Whilst in theory data linkage is a powerful mechanism for obtaining population-level data, in reality, there are many logistical and financial barriers to linking multiple datasets. Consequently, critical data, which has the potential to inform policy and improve patient outcomes, cannot be procured.

Key messages

Logistical and financial challenges are associated with linking administrative and registry datasets for research, limiting the potential of data linkage.
59Outbreak investigation of dengue fever in union council (UC) Bharakahu, Islamabad, Pakistan, 2019
Authors: Khan Sajjad Ahmad Khan Sajjad
Published: September 2021

Background

During third week of September 2019, lady health workers reported twelve suspected cases of dengue fever from UC Bharakahu, Islamabad (population 70,000) to health department. Outbreak investigation conducted with objectives to determine risk factors and recommend control measures.

Methods

Investigation conducted from 20th September to 04th November 2019. Case was defined as any resident of UC Bharakahu with fever and two or more of following signs/symptoms; headache, retro-orbital pain, arthralgia, myalgia, petechial rash with NS1 (Nonstructural Protein 1) positive during 12th August to 18th November 2019. Age and sex matched healthy controls recruited from same neighborhood. Blood samples from seven suspected cases sent for laboratory confirmation.

Results

Total 993 houses surveyed and 113 cases identified. Mean age was 34.2 years (range 13-90 years). Most affected age group was 35-44 years (Attack Rate 0.78%), Overall attack rate was 0.15%. Males were predominantly involved n = 70 (62%). Out of total cases, 34 (70%) had stagnant water inside and around houses (OR 2.0, CI 1.06-3.75, p < 0.005), 40 (35%) used repellent lotions (OR 0.55, CI 0.32-0.95, p < 0.05), 34 (30%) used insecticide spray (OR 0.35, CI 0.20-0.61, p < 0.05), 97 (86%) used full protective clothing (OR 0.22, CI 0.07-0.68, p < 0.05). All seven blood samples tested positive for NS-1 Ag.

Conclusion

Presence of stagnant rain water inside and around houses acted as breeding grounds for aedes aegypti mosquitoes and was most probable cause of outbreak. Following our recommendations, health department initiated mosquito breeding sites control activities through insecticide residual spray and advocacy on use of protective measures against mosquito bites.

Key words

Outbreak, dengue, stagnant water, Bhara Kahu, Islamabad, 2019
722Prevalence and predictors of internet addiction among college students in Jodhpur city, India
Authors: Setty Naveen Kikkeri Hanumantha , Rajasekhar Thota , Raghav Pankaja , Aneja Jitender , Gupta Manoj Kumar , Sharma Prem Prakash , Goel Akhil Dhanesh , Srinivasan Srikanth , T Prasanna
Published: September 2021

Background

Globally, the prevalence of internet addiction (IA) varies from 6% to 58% and emerging as a signiﬁcant behavioural addiction pandemic often coexisting with psychological problems. This study was done to estimate the prevalence and predictors of internet addiction among undergraduate college students of Jodhpur city.

Methods

Cross sectional study was done among 2035 college students of Jodhpur city between August 2018-October 2019. The study tool consisted of self-administered questionnaire including socio-demographic details, Young’s internet addiction scale, Pittsburgh Sleep Quality Index (PSQI) and DASS 21scale. Univariate and multivariate analysis was done using SPSS v.23.

Results

The prevalence of internet addiction was 51.0% (95% CI:48.8%-53.2%). Depression, anxiety and stress were highly correlated (r > 0.7). Hence, 3 separate binary logistic regression models were constructed. The predictors of IA common among all 3 models were male sex, age ≥20 years, age at first internet use ≤15 years, urban origin, accessing internet at college, mobile internet use, preference to make online friendship and sleep disturbance. Staying in hostel or paying guest accommodation was predictor in model 2 and 3. Students who screened positive for Depression, anxiety and stress had higher odds of IA.

Conclusions

Nearly half of study participants were internet addicts. IA was associated with depression, anxiety, stress and sleep disturbance.

Key messages

The study highlights the need for screening and management of both internet addiction and associated mental health problems with special focus on males and those staying away from home.
1092Questioning health inequality as policy agenda in Korea: using Luke’s three-dimensional theory of power
Authors: Kim Saerom , Kim Myoung-Hee
Published: September 2021

Focus of Presentation

Health inequality is an important public health concern in Korea. However, policies to reduce health inequalities still falls behind. This research focus on political agenda making process of health inequality. To achieve this aim, we utilized Lukes’ three-dimensional theory of power to explain current state of ‘health inequality’ as political agenda in South Korea.

Findings

We conducted 12 in-depth interviews with 6 policymakers and 6 practitioners, and focus-group interview with 5 researchers in 2016. From the qualitative analysis, we constructed 3 main themes. First theme, the perception, participants’ perspective on health inequality varied widely. Some participants assumed health inequality in Korea as an inevitable social condition, not even a problem to be tackled. Despite differing views on the condition, most participants attributed health inequality as result of accumulated result of socio-economic inequality.

Second theme, the barriers, many claimed health inequality too abstract, complex, and ambiguous concept to be politicized. Policy actors saw current political apathy to paucity of empirical evidence, which was the complete opposite to the researchers.

Third theme, the supression, was analyzed using luke's theory of power. On first dimension, the pluralistic power, conservative government has been marginalizing overal inequality issue. On second dimension, two major obstacles of growth-first policy and result-ased management of bureaucratic organization were found. On third dimension, the governmentality, 3 mechanisms that suppress health inequality were found. Those were medicalization of health, neoliberal discourse that individualize health as personal asset, and policy monopoly by 'health insurance' that absorbe every health-related issue.

Conclusions/Implications

In conclusion, we derived five propositions for making health inequality a policy agenda in Korea. Strong political leadership to tackle structrual inequality is needed, more decentralized, democratic governance system should be founded, intersectoral approach and comprehensive intervention for health inequality should be implemented, alternative health regime to reorganized current medicalization of health should suffuse, finally, more knowledge and experience to denaturalize health inequality should be followed.

Key messages

To tackle health inequality, power that supress health equity becoming policy agenda should be anlalized.
809Sodium/potassium ratio change was associated with blood pressure change: finding from health check-up data
Authors: Kogure Mana , Nakaya Naoki , Hirata Takumi , Tsuchiya Naho , Nakamura Tomohiro , Narita Akira , Suto Yoko , Honma Yoko , Sasaki Hidemi , Miyagawa Ken , Ushida Yusuke , Ueda Hiroyuki , Hozawa Atsushi
Published: September 2021

Background

The sodium (Na)/potassium (K) ratio was reported to be associated with blood pressure (BP). Recently, the Na/K ratio self-monitoring device using spot urine was established. We assessed whether the urinary Na/K ratio change measured using the Na/K device was positively associated with BP change in a health check-up setting.

Methods

We targeted 12,890 participants who attended the annually health check-up in Tome City, Miyagi Prefecture, Japan between 2017 and 2018. Tome city introduced urinary Na/K ratio measurement during health check-up since 2017. We assessed the relationship between change in urinary Na/K ratio and BP change using multiple regression analyses adjusted for age, sex, and change in body mass index (BMI) and alcohol intake. For each year, we compared the baseline characteristics according to the urinary Na/K ratio and BP level.

Results

The change in systolic BP and diastolic BP was positively associated with the change in urinary Na/K ratio. The average urinary Na/K ratio was significantly lower in 2018 than in 2017 (5.4±3.0 to 4.9±2.2, p < 0.01). Moreover, their systolic BP in 2018 (130.9±17.4 mmHg) was lower than that in 2017 (132.1±17.9 mmHg) (p < 0.01).

Conclusions

The positive association of change in urinary Na/K ratio with hypertension and change in systolic and diastolic BP can be explained by a change in alcohol intake, BMI, and urinary Na/K ratio.

Key messages

Measuring the urinary Na/K ratio in community settings is a potential population approach for counteracting hypertension.
946HIV prevalence and common risk factors in three at-risk populations in Vietnam
Authors: Lee Patricia Chiaotzu , Docrat Ashraf
Published: September 2021

Background

Despite the continuing decline of HIV/AIDS incidence and prevalence in the general population of Vietnam, HIV rates remains high in three key subpopulations: injecting drug users (IDUs), men who have sex with men (MSM) and female sex workers (FSWs). This study aims to identify the common sociodemographic characteristics and behavioural risk factors among three key populations for HIV infection in Vietnam.

Methods

This study used a systematic review and meta-analysis to synthesise findings from published studies on HIV prevalence and associated risk factors among the three at-risk groups. Five electronic databases were used to identify peer-reviewed articles in relevant topics. Comprehensive Meta-Analysis software was used to estimate pooled prevalence in the combined study population and to determine the effect sizes of the common risk factors on HIV outcome.

Results

Of the 18 included studies, 6 focused on IDUs, 8 on FSWs and 4 on MSM, accounting for a total of 16,304 participants. The overall prevalence of HIV among the three at-risk groups based on meta-analysis was 11.8% (95%CI: 0.072-0.188). The identified common risk behaviours for HIV infection included injecting drug use (OR: 21.3, 95%CI: 6.5-69.3), sharing injecting equipment (OR: 4.2, 95%CI: 2.1-8.2) and inconsistent condom use (OR: 2.6, 95%CI: 1.5-4.4). The associated socio-demographic characteristics with HIV (+) included young age, single/ unmarried, low education and income.

Conclusions/Key messages

The findings of this study suggested that injecting drug use may can contribute to developing more affective prevention measures targeting these high-risk groups and reducing the risk of HIV transmission to the general population.
1240Socioeconomic Inequalities in Adolescent Metabolic Syndrome and Depression: no mediation by parental depression and parenting
Authors: Lepe Alexander , Reijneveld Sijmen A. , Almansa Josué , de Winter Andrea F. , de Kroon Marlou L.A.
Published: September 2021

Background

We assessed to what extent parental depression and parenting style mediate the relationships between different measures of parental socioeconomic status (SES) and both depression and metabolic syndrome (MetS) in adolescents, and whether these mechanisms differ by sex.

Methods

Data were from the prospective multigenerational Dutch Lifelines Cohort Study. Our sample consisted of 1,217 adolescents with an average follow-up of 33.3 (SD = 7.33) months and a median baseline age of 13 (IQR:13-14) years. We used structural equation models to assess the direct and indirect effects of SES on baseline and changes at follow-up in both depression and MetS, and to assess moderation by sex.

Results

Parental education had a small direct effect on adolescent cMetS. For each additional year of education, cMetS scores were 0.098 (95%CI: 0.020; 0.184) units lower at baseline and decreased 0.079 (95%CI: 0.004; 0.158) units at follow-up. No indirect effects via parenting style or parental depression were found, and there was no moderation by sex. Additionally, parenting style was consistently associated with baseline cMetS and depression, and improvements in parenting style were consistently associated with decreasing depression scores.

Conclusions

The results indicate that improving parenting style may improve health for all adolescents. However, in this study parental depression and parenting style did not account for adolescent socioeconomic health inequalities. This may be partly due to good access to social services within the Netherlands.

Key messages

Improvements in parenting style may improve adolescent health. Additionally, pathways to counteract socioeconomic differences require further elucidation.
1313Is private rental instability bad for mental health?
Authors: Li Ang , Bentley Rebecca
Published: September 2021

Background

People in the private rental sector move more than people in other tenures. Yet we know little about the consequences for health of this instability. We are the first to use a nationally representative longitudinal survey of Australians (2000-2018) to causally examine mental health effects of residential instability for a low-income working-aged cohort of private renters.

Methods

Mental health was measured using the SF-36 (MH) and Kessler Psychological Distress scale (K10). We examined effects of 1) cumulative time spent in private rental compared with other sectors (homeowner or social housing), 2) total numbers of transitions, and 3) average numbers of transitions within 5 years, using marginal structural models to account for complex confounding of tenure, socio-economic position, and mental health over time.

Results

The mental health of private renters was similar to homeowners at initial occupancy but became worse after one to five years. The more moves private renters made, the worse their mental health, with people who had >five moves in total reporting a -3.77-point (95%CI -6.79; -0.75) difference on MH and -3.84-point difference (95%CI -7.61; -0.07) on K10 (rescaled). If numbers of moves were small, the mental health of private tenants was better than social tenants. When moves were frequent, however, their mental health scores became similar.

Conclusions

Residential instability negatively affects mental health. Frequent moves in private rental worsen tenants’ mental health compared to owners.

Key messages

Reducing housing instability in lower-income households in private rental with greater protection from forced moves will increase resident’s wellbeing.
185Online teaching of epidemiology and biostatistics: where do we go from here?
Authors: Lin Sophia , Craig Adam , Heywood Anita
Published: September 2021

Focus of Presentation

There has been a global proliferation of fully online programs in public health. There is a dearth of information on how to best deliver epidemiology and biostatistics education to students studying online. This may be due to the relatively few changes in the teaching of introductory epidemiology and biostatistics over the past several decades. This presentation reflects on our experiences in teaching these subjects. We pose some key research questions that may drive innovation of teaching to better prepare public health graduates.

Findings

Asynchronous online teaching of epidemiology and biostatistics brings both benefits and challenges. Novel methods of engaging students, supporting self-regulation of learning, building communities of practice, and other strategies to encourage active and deep learning need to be identified. Evidence for both student satisfaction and performance from effective online teaching of epidemiology and biostatistics is critical but currently lacking.

Conclusions/Implications

Given the growth in online delivery of tertiary education, evidence is required to determine best practice around quality online teaching of epidemiology and biostatistics. Researchers should use their unique skills in causal thinking to innovate methodologies to support evidence-based and quality assured teaching of epidemiology and biostatistics.

Key messages

The teaching of epidemiology and biostatistics is an essential part of ensuring a skilled public health workforce. Educational research should prioritise effective teaching strategies suited to the online learning environment and future-proof programs for online delivery.
682Do job stressor—mental health relationships vary by migrant status? An Australian comparative analysis
Authors: Liu Xiaomin , LaMontagne Anthony , Bowe Steven , Li Lin , Too Lay San
Published: September 2021

Background

Migrants may be more likely to experience occupational health inequities (OHIs) than native-born workers due to higher occupational exposure, higher vulnerability to exposure-associated health impacts, or both. This study explores migrant status-related differences in vulnerability to job stressor exposures in terms of mental health in Australia.

Methods

Data were from wave 14 of the Household Income and Labour Dynamics in Australia Survey. Migrant status was defined by country of birth (COB), the dominant language of COB, and the years since arrival in Australia. Job stressors included skill discretion, decision authority, and job insecurity. Mental health was assessed using the Mental Health Inventory-5 score (MHI-5). Data were analysed using linear regression, adjusting for gender, age, and education. Migrant status was analysed as the effect modifier of job stressor—mental health relationships.

Results

As expected, skill discretion and decision authority were positively, while job insecurity was negatively associated with the MHI-5 score. However, there was no statistical evidence of migrant status acting as an effect modifier of job stressor—mental health relationships even though the dominant language of COB and years since arrival in Australia have been taken into account.

Conclusions

The magnitudes of job stressor—mental health relationships do not differ between migrant workers and Australia-born workers.

Key messages

Differential exposure rather than differential vulnerability is a more important mechanism for generating occupational mental health inequities between migrants and Australian-born workers. Reducing job stressor exposures could reduce the OHIs among migrant workers in Australia.