bluuebunny/crossref_metadata_2025_split huggingface dataset:
936Descriptive study of healthy life expectancy in all secondary medical areas in Japan
Authors: Ojima Toshiyuki , Hosokawa Rikuya , Myojin Tomoya , Aida Jun , Kondo Katsunori , Kondo Naoki 
Published: September 2021

Abstract

Background
Healthy life expectancy (HLE) is an index combined with mortality and morbidity. Monitoring HLE is useful to assess and stimulate health promotion policies/programmes. Though HLE in national or prefectural areas have often been observed, further data in smaller areas are required. The aim of the study is to reveal descriptive features of HLE in secondary medical areas, that is almost same as public health centre jurisdictions and median of population is 214 thousand, in Japan.

Methods
HLE by gender in all 341 secondary medical areas were calculated using Sullivan method. Population data was used from resident registry. Mortality data was from vital statistics of total death in 2016-2018. Data of proportions of unhealthy people was from long-term care insurance data in 2017 using proportion of people with care level 2 (almost bed ridden level) or more severe. Finally, maps of HLE of all of Japan were drawn.

Results
Means (standard deviations, maximums, minimums, means of ranges of 95% confidence intervals) of HLE at birth are 79.21 (0.86, 81.36, 76.90, 0.92) and 83.75 (0.62, 85.45, 81.99, 0.80) years for males and females, respectively. Areas with short HLE were prevalent in Tohoku region (northern part), while that with long HLE in Chubu region (central part).

Conclusions
Descriptive features of HLE in smaller areas of all of Japan can be firstly clarified.

Key messages
Monitoring HLE in local areas would be feasible and useful in some countries. Precision of HLE of areas of these population size would be acceptable.
1031Predictors of Lung function change over the life course: a systematic review
Authors: Okyere Daniel , Waidyatillake Nilakshi , Bui Dinhi , Lowe Adrian , Perret Jenny , Lodge Caroline , Dharmage Shyamali 
Published: September 2021

Abstract

Background
Throughout life, lung function increases, peaks, plateaus and declines. These phases can be influenced by several exposures. Despite the growing body of evidence, the association between these factors and lung function change over the lif course has not been systematically reviewed.

Methods
Using a pre-defined protocol, two authors independently identified publications related to lung function trajectories and extracted relevant information. We included studies that identified/developed/modelled/reported lung function trajectories based on at least three-time points. Due to heterogeneity in the exposures and methods used to model lung function trajectories, it was not possible to conduct a meta-analysis.

Results
A total of 12 population-based cohort studies met the inclusion criteria. Of these, 10 were birth cohorts. 4 studies used cluster analysis techniques to develop trajectories while the others used generalized linear interactive modelling. Eight factors were identified, by 2 or more studies, as predictors for reduced lung growth, decline and/or persistently low trajectories. They were low birth weight and parental asthma (n = 2); childhood asthma and allergic sensitization (n = 4); childhood lower respiratory tract infections and childhood persistent wheezing, and environmental tobacco smoke (n = 3); and childhood eczema (n = 2).

Conclusions
Our review identified risk factors for lung function change that have been consistent at least across two studies.

Key messages
These findings suggest preventive measures directed at childhood asthma and infections, and tobacco exposure will help promote lung health and prevent unhealthy lung function trajectories.
400Overactive bladder with/without urinary incontinence and falls in the community-dwelling elderly
Authors: Omae Kenji , Kurita Noriaki , Takeshima Taro , Naganuma Toru , Takahashi Sei , Yoshioka Takashi , Ohnishi Tsuyoshi , Ito Fumihito , Hamaguchi Sugihiro , Fukuhara Shunichi 
Published: September 2021

Abstract

Background
Little is known about the fall risk of older adults with overactive bladder (OAB), especially in the absence of urgency incontinence (UI).

Methods
This prospective cohort study included 630 community-dwelling, independent older adults 75 years old or older who attended a health check-up in 2017 with a 1-year follow-up. The associations of OAB with and without UI (OAB-wet and OAB-dry) with a fall history, and future fall risk compared to no OAB were assessed using logistic regression models. The contribution of OAB as a predictor of falls was examined using a random forest and decision tree approach.

Results
Of the 577 analyzed participants (median age 79 years), 273 were men. The prevalence of OAB-dry and OAB-wet at baseline was 15% and 14%, respectively. Multivariable logistic regression analysis revealed that both OAB-dry and OAB-wet were associated with a higher likelihood of prior falls (adjusted ORs vs no OAB 2.03 and 2.21, respectively; 95% CI 1.23–3.37 and 1.29–3.78, respectively). Among the 363 participants without a fall history, the adjusted ORs (95% CIs) of OAB-dry and OAB-wet for the occurrence of falls during the 1-year follow-up were 2.74 (1.19–6.29) and 1.35 (0.47–3.87), respectively. The tree-based approach used for all participants showed that OAB was an important predictor of falls in adults without a fall history.

Conclusions
OAB, even in the absence of UI, is an important predictor of falls in older adults with a low absolute fall risk.

Key messages
Our findings suggest that OAB is a risk factor for falls in the community-dwelling elderly irrespective of the presence of UI.
602Prevalence of cancer history and association with risk factors in a healthy older population
Authors: Orchard Suzanne , Lockery Jessica , Gibbs Peter , Polehkina Galina , Wolfe Rory , Zalcberg John , Haydon Andrew , McNeil John , Nelson Mark , Reid Christopher , Kirpach Brenda , Murray Anne , Woods Robyn 
Published: September 2021

Abstract

Background
The ASPirin in Reducing Events in the Elderly (ASPREE) study randomised healthy older individuals to 100mg aspirin or placebo, with clinical outcomes and disability-free survival endpoints. Detailed baseline data provides a rare opportunity to explore cancer burden and association with known cancer risk factors in this population.

Methods
At enrolment (2010-2014), self-reported personal cancer history, cancer type and cancer risk factor data were sought from 19,114 participants (Australia, n = 16,703; U.S., n = 2,411). Participants were healthy and expected to survive 5 years.

Results
Of those reporting a prior cancer diagnosis (18% women, 22% men), women were diagnosed younger (16% vs 6% of diagnoses &lt;50 years). Cancer prevalence increased with age. Prostate and breast cancer history were higher in U.S. participants; melanoma and colorectal cancer were higher in Australian participants. Cancer history prevalence was not associated with any common risk factors, but was associated with poor health ratings in men. Blood and breast cancer history was more common with past aspirin use.

Conclusions
Personal cancer history in healthy older ASPREE participants was as expected for the most common cancer types in the respective populations. The lack of alignment with known risk factors is attributable to survivor bias, driven by entry criteria, and to possible molecular differences in cancer between elderly and younger people.

Key messages
As the prevalence of cancer increases with age, the lack of alignment with known risk factors implies other factors play a significant role.
447Decoding the effect of neighbourhood on arterial health (DEpICT): Preliminary results on neighbourhood self-evaluation
Authors: Panayiotou Andrie , Photiou Galateia , Panagiotakos Demosthenis , Middleton Nicos 
Published: September 2021

Abstract

Background
DEpICT is an ongoing exploratory, observational, cross-sectional study in community-dwelling individuals in Limassol, Cyprus aiming to combine individual-level and community-level risk factors to decode their effect on arterial health (stiffness) as measured with pulse wave velocity (PWV).

Methods
Participants are &gt;40 years and living in the same address for ≥5 years. They provide personal information on quality of life and mental health (SF-12 and GHQ-12), physical activity (IPAQ), adherence to Mediterranean diet (MedDiet) and sociodemographic. Arterial stiffness is measured as PWV. Neighborhood is self-assessed using the “Place Standard” Tool, as well as independent neighborhood audit with the newly-developed CyNoTes tool.

Results
Mean age of the first 176 participants (53%male) was 55.2 (±8.6). All participants rated their health between excellent/very good (50.5%) and good/modest (49.5%), however participants with a higher net family income reported significantly better health (p for trend=0.02), with 61.4% reporting very good/excellent health in those earning &gt;2000E Vs 40.2% in those earning ≤ 2000E/m (p = 0.005). Out of 14 constructs in “Place”, “Public transport” and “Participation and sense of control” were rated lowest (3.1 ± 1.9 and 3.1 ± 1.8) and “Identity and sense of belonging” and “Safety” highest (4.1 ± 1.9 and 4.5 ± 1.8). Out of these, family income was associated with “Safety” (p = 0.005) and self-health with “Participation and sense of control”.

Conclusions
Participants rate social and safety aspects of their neighborhood higher than build aspects.

Key messages
Participants express the need for more public engagement in community decision-making; sense of lacking control may affect individual health.
663“To tell or not to tell...” Practice of (non)disclosure and collusion of cancer in India
Authors: Parsekar Shradha S. , Nair Suma 
Published: September 2021

Abstract

Introduction
Collusion and concealing cancer diagnosis is often practiced in India. To get more insights on the perception and practice of disclosing cancer diagnosis, a qualitative study was conducted in south India.

Methods
In-depth interviews were conducted separately among women diagnosed with breast cancer and their caregivers. Prior permissions from hospital administration and ethical clearance was obtained. Using purposive sampling, 39 caregivers and 35 women diagnosed with breast cancer were recruited from tertiary care hospital.

Results
Families practiced collusion so as to protect the patient from emotional consequence viz. shock, fear of death and uncertainty about prognosis and treatment. This practice was more common among families who had patient with advanced stage of illness and/or 49 years of age and above. Collusion was mostly seen among Participants concealed the cancer diagnosis from social contacts such as extended family, friends and neighbor. Resultant codes pertaining to nondisclosure were; ‘too many questions’, ‘avoid courtesy visits’, ‘negative suggestions’, ‘perceived stigma’, ‘obstacle in child’s marriage’, and ‘shock’.

Conclusions
Disclosing cancer diagnosis is considered as ‘bad news’ however, withholding information about health status of patient is not ethically appropriate. Additionally, nondisclosure resulted in diminished support from social contacts. Concordance between cancer diagnosis and patients’ ability to deal with the information is important.

Key messages
Although nondisclosure of cancer diagnosis and prognosis violates patient autonomy, it was perceived to be beneficial for the patient. A pragmatic disclosure strategy complemented with tailored counselling would be a feasible paradigm.
1340A Trial of Modern Sample Frames and Modes: The WA Health and Wellbeing Surveillance System
Authors: Patterson Candice , Dombrovskaya Mikhalina , Landrigan Tim 
Published: September 2021

Abstract

Background
The Health and Wellbeing Surveillance System (HWSS) monitors the health status of the WA population. Its reliance on a landline sample frame and Computer Assisted Telephone Interview (CATI) must shift to mobile phone sample frames and novel online completion options, improving the representativeness of the HWSS data to the WA population.

Methods
Concurrent surveys in 2020 were run using three sample frames, the 2013 Electronic White Pages (EWP), the WA Electoral Roll (WAER) and a Sensis consumer database. The survey modes explored included CATI, online, and dual mode. Responses were weighted to the WA population. Response rates were compared between frames and modes. Differences in demographics, health risk factors, conditions and behaviours were investigated by comparing prevalence estimates and logistic regression modelling.

Results
Response rates were 20% for EWP CATI, 41% for Sensis CATI, 16% for Sensis online, and 10% for WAER online. Compared to EWP, the WAER and Sensis frame respondents were younger, had higher incomes and better education. Online respondents had higher prevalence of high psychological distress and lower prevalence of smoking compared with CATI.

Conclusions
The WAER and Sensis consumer database are valid sample frame options for the future of the HWSS. CATI gave the highest response rates, yet respondent differences by frame and mode were evident. WA Health is further exploring these options of modern sample frames and survey modes in 2021.

Key messages
Population health surveillance systems must modernise their sample frames and data collection modes to continue to provide reliable health prevalence estimates.
154Physical inactivity, socioeconomic position and type 2 diabetes in Nepal: a structural equation modelling analysis
Authors: Paudel Susan , Tran Thach , Owen Alice , Smith Ben 
Published: September 2021

Abstract

Background
Type 2 diabetes mellitus (T2DM) is emerging as a major public health challenge in Nepal. Behavioural, social and economic changes are likely to play a part in the rise of this chronic disease, as they are in many developing countries. A better understanding of the relationship between physical activity (PA), social and economic factors and T2DM can inform the design of prevention programs.

Methods
This study analysed data from 1977 Nepalese adults aged 40-69 years from the 2013 WHO STEPS survey. Socioeconomic position was determined based on education, occupation and ethnic group. Participants’ fasting blood glucose level was used to ascertain their diabetes status. Structural equation modelling was conducted to identify the regression pathways between PA, socioeconomic position, anthropometric and metabolic variables and T2DM.

Results
The overall prevalence of T2DM was 9% with almost double the burden among urban residents (17 %). Socioeconomic position (0.338), waist circumference (0.250), triglycerides (0.115) and hypertension (0.129) had a statistically significant direct effect on T2DM. PA had an indirect effect on T2DM mediated by waist circumference (-0.015). The indirect effects of socioeconomic position on T2DM were mediated by body mass index, waist circumference, triglycerides and total cholesterol.

Conclusion
Policies and programs to address T2DM in Nepal should address the factors contributing to unhealthy weight status, particularly among those of higher socioeconomic status.

Key message
Among Nepalese adults, higher socioeconomic position has a significant direct effect on T2DM, while both PA and higher socioeconomic position have significant indirect effects.
894Molecular epidemiology: building causal evidence within highly dimensioned studies
Authors: Ponsonby Anne-Louise 
Published: September 2021

Abstract

Focus of Presentation
This presentation provides a practical perspective on molecular epidemiologic analysis within a single high dimensional study to consider a causal question.

Findings
The work steps include special issues. Those include composite exposures and understanding of collinearity across predictors. Laboratory artefact needs to be minimised. Non-causal confounding is also important. This can occur when a factor is a determinant of outcome and the underlying association between exposure and the factor is non-causal. That is, the association arises due to chance, confounding or other bias rather than reflecting that exposure and the factor are causally related. The influence of laboratory processing features must be accounted for. This can be achieved by pre-processing measures to remove artefact or controlling for process factors. The work plan should allow the evaluation of alternative non-causal explanations for observed exposure-disease associations and strategies to obtain the highest level of causal inference possible within the study.

Conclusions/Implications
A systematic approach is required to work through a question a question set and obtain insights on not only the exposure-disease association but the multifactorial causal structure of the underlying data where possible. The appropriate inclusion of molecular findings will enhance the quest to better understand multifactorial disease causation in modern observational epidemiological studies.

Key messages
A systematic set of work steps is outlined to assess whether detected exposure-disease associations have a low and high likelihood of being attributed to non-causal and causal explanations respectively.
1419Cancer mortality burden and quality of life in Argentina: geographical pattern and measures of association
Authors: Pou Sonia Alejandra , Niclis Camila , Tumas Natalia , Aballay Laura Rosana , Diaz Maria del Pilar 
Published: September 2021

Abstract

Background
Health outcomes are often related to the conditions in which people live. Previous studies indicated that cancer mortality is non-randomly distributed between social groups and regions in Argentina. We aimed to analyze geographical pattern of mortality due to the most prevalent cancers in Argentina (2013-2015), from a quality of life approach.

Methods
Age-standardized mortality rates (ASMR) for specific cancer types (breast, lung, prostate, colon, cervix, stomach) was estimated by direct method (2013-2015 period). Mortality maps at a departmental scale (n = 511) were constructed by using a Getis-Ord Hot Spot spatial analysis. A Quality of Life Index (QLI, continuous score) for Argentina 2010 was used. Poisson mixed models with a random intercept were performed to estimate IRRs (relative risk) as measures of association.

Results
Breast, lung, and colon cancers show the most clear ASMR geographical patterns, which locate an extensive cold spot (lower and correlated rates) in the northwestern region of Argentina and a hot spot (higher and correlated rates) in the Pampeana (center-east) region . Particularly, breast and cervix cancers showed confronting mortality geographic patterns and opposite relationships with the departmental QLI (IRR 1.23 and 0.78, respectively). A direct association was found for lung (IRR 1.46/1.15 for women/men) and colon cancer (IRR 1.57/1.49 for women/men).

Conclusions
Results evidence geographic disparities in cancer mortality burden linked to the quality of life of populations at departmental scale in Argentina.

Key messages
Geographic disparities in cancer mortality are linked to the quality of life in Argentina.
Mortality-QLI relationship varies according the cancer type.
965The estimated impact of improved breast screening tests targeted at women with dense breasts
Authors: Procopio Pietro , Velentzis Louiza , Dennis Petrie A , Mann G Bruce , Kavanagh Anne M , Ray Watson A , Saxby Karinna , Korevaar Elizabeth , Carr Sarah , Bromley Hannah , Canfell Karen , Nickson Carolyn 
Published: September 2021

Abstract

Background
There is increasing interest in risk-based breast cancer screening, including interventions to improve outcomes for women with mammographically dense breasts.

Methods
Policy1-Breast is a continuous-time, multiple-cohort micro-simulation whole-population model which incorporates breast cancer risk, life-course breast density, menopause, hormone therapy use and screening participation. Outcomes include cancer diagnoses and characteristics (invasive/DCIS, tumour size, grade), mode of detection (screen-detected/interval/other) and mortality (breast cancer and other cause). Policy1-Breast validates well against key observed clinical outcomes in Australia. We estimate changes in outcomes within and outside the BreastScreen program upon the introduction of a hypothetical screening test with improved sensitivity for women with dense breasts.

Results
We estimate that introducing in year 2020 a screening test for women in the highest quintile of breast density at age 50 that halves the masking effect of their breast density would, by 2026-2030, increase diagnosis rates of population-level invasive cancers ( 10%) and screen-detected cancers (20%) and decrease rates of interval cancers (17%) and community-detected cancers (6%).

Conclusions
Targeted screening tests with improved sensitivity for women with dense breasts are expected to markedly reduce interval cancers and other cancers diagnosed outside the BreastScreen program, while increasing all cancer diagnoses due to increased rates of screen-detected cancers.

Key messages
Specialised breast cancer screening tests directed at women with very high breast density are expected to reduce interval cancers and increase overall cancer diagnoses. Population simulation models such as Policy1-Breast can complement trial evidence by evaluating a range of scenarios and estimating short and long-term implications.
356Impact of site-specific and patient-specific factors in explaining HbA1c variation in Australian diabetes centres
Authors: Quigley Matthew , Earnest Arul , Szwarcbard Naomi , Wischer Natalie , Andrikopoulos Sofianos , Green Sally , Zoungas Sophia 
Published: September 2021

Abstract

Background
Management of glycaemia remains the mainstay of optimal diabetes care. As reported by the Australian National Diabetes Audit (ANDA) average glycaemia is suboptimal for many people living with diabetes. Whether centre-specific factors influence HbA1c variation among patients attending Australian primary, secondary or tertiary diabetes centres, is not known.

Methods
Data for 5,872 people with Type 1 or Type 2 diabetes (DM1/DM2) was collected for ANDA over a 4-6 week period. A linear mixed-effects model was built to examine the relative contribution of centre-specific (type of centre, location and volume of patients) and patient-specific factors in explaining variation in HbA1c, by diabetes type.

Results
Mean age of the cohort was 57.5±17.2 years, median disease duration 14 years (7,21) with 47% female. For people with DM1, number of patients was the only centre-specific factor that significantly contributed to HbA1c variation (p = 0.019). In contrast, for people with DM2, type of centre significantly contributed toHbA1c variation (p &lt; 0.001). Patient-specific factors contributing to HbA1c variation included prior hyperglycaemic emergencies, being a non-smoker and Aboriginal or Torres Strait Islander status.

Conclusions
Unlike patient factors, centre factors such as type, location and volume of patients appear to have less actionable impact on HbA1c variation.

Key messages
Centre-level interventions to target patient-specific factors (such as sick day management education to prevent acute hyperglycaemia, smoking cessation programs and culturally appropriate diabetes education) rather than centre-specific factors may be more important for improving glycaemia.