bluuebunny/crossref_metadata_2025_split huggingface dataset:
112Neighbourhood environment and health-related quality of life, Limassol, Cyprus
Authors: Ellina Panayiota , Middleton Nicos , Kleopa Daphne , Panayiotou Andrie , Nicolaou Christiana , Lambrinou Ekaterini , Kouta Christiana 
Published: September 2021

Abstract

Background
The extent and magnitude of socio-geographical inequalities in health in Cyprus is not clear as neither “place” nor “health inequalities” feature on the public health agenda.

Methods
In the context of a wider Neighbourhood Environment and Health programme, the magnitude of inequality in health-related quality of life (HRQoL) among Limassol citizens was explored in a door-to-door SF-36 survey of residents aged 45-64 (N = 450, 50:50 gender quota) across 45 randomly selected neighbourhoods stratified by socio-economic disadvantage and profiled using a culturally-adapted Systematic Social Observation neighbourhood audit tool.

Results
The social gradient was steeper for physical than mental component scores of HRQoL irrespective of the indicator of social position. Education and income captured the gradient better in women, and occupational-based social class in men, with large effect (0.7-1 SD) on the SF-36 scale at opposite ends of the continuum. Lower HRQoL and more adverse health behaviours observed in disadvantaged neighborhoods according to census area-level measures and neighbourhood audit profiles, with generally larger differences in women.

Conclusions
This study profiled the variability in the urban neighbourhood environment,and documented the magnitude of social gradient in health and health-related quality of life in a representative sample of late working-life population in Cyprus.

Key messages
Social gradient in health behaviours and quality of life in late working-life Cypriot population.
Gradient apparent in both men and women across individual and neighborhood measures of social position.
1484Selection bias in COVID-19 research: Prospective analyses of two UK cohort studies
Authors: Fernández-Sanlés Alba , Carter Alice , Millard Louise , Smith Dan , Griffith Gareth , Clayton Gemma , Hughes Rachel , Morris Tim , Lawlor Deborah , Tilling Kate , Borges Maria Carolina ,   on behalf of the COVIDITY working group
Published: September 2021

Abstract

Background
Non-random sampling could bias estimates of association in observational studies but the extent to which this occurs in studies of SARS-CoV-2 infection/COVID-19 severity is not well established.

Methods
Using ALSPAC and UK Biobank we investigated pre-pandemic predictors of selection (i.e. having data on SARS-CoV-2 infection and COVID-19 severity from self-report and/or health record linkage). We conducted empirical analyses and simulations to explore the potential presence, direction and magnitude of bias due to selection when estimating the association of BMI with SARS-CoV-2 infection and COVID-19 severity.

Results
A broad range of characteristics related to selection in both cohorts, sometimes in opposite directions. We found bias in all simulated scenarios, mostly of small magnitude. Both the direction and magnitude of bias was influenced by the presence of an effect of BMI on SARS-CoV-2 infection and COVID-19 severity and the control group definition used (e.g. assuming no effect of BMI on SARS-CoV-2 infection our main simulation showed bias equivalent to an estimated odds ratio of 0.99 when using non-infected controls but 1.16 when using controls combining non-infected and non-assessed).

Conclusions
Despite small amounts of bias in most scenarios, a control group definition including those non-assessed (e.g. non-tested) can induce more bias. In large samples such as UK Biobank the statistical power means incorrect conclusions could be made.

Key messages
Observational studies estimating associations of factors with SARS-CoV-2 or COVID-19 may be biased due to non-random selection into the analytic sample.
88The Role of Visceral Adiposity in the Metabolic Phenotype of multi-ethnic South-East Asian population
Authors: Mina Theresia ,   The HELIOS Study team, ES Lee , Lee Jimmy , Loh Marie , Ngeow Joanne , Elliott Paul , Riboli Elio , Chambers John 
Published: September 2021

Abstract

Background
Ethnic Asians are known to exhibit worse metabolic phenotypes as compared to Caucasians despite lower body mass index1, 2. Ethnic South-Asians and Malays were also found to display greater insulin resistance than Chinese3. One potential biological mechanism for this phenomenon is the inter-ethnic differences in the visceral adiposity deposition4. Here we hypothesised that visceral adiposity contributes to ethnic differences in metabolic phenotype more than subcutaneous adiposity.

Methods
We quantified total, subcutaneous and visceral adipose deposition (BMI, waist circumferences, Dual-energy X-ray absorptiometry [DEXA]) and metabolic phenotypes (blood pressure, fasting glucose and lipid profile, HbA1c) in 3403 participants. Analyses were adjusted for age, and sex.

Results
Participants were 40.6% male, mean age 49.7±11.4 years, Chinese: Malays: South-Asians in 72:9:19 ratio. Ethnic Malays and South-Asians had raised blood pressure, fasting glucose, triglycerides, HbA1c, reduced HDL, and higher total and visceral fat than Chinese (P &lt; 0.001), independent of covariates. Increased adiposity was strongly associated with poorer metabolic phenotype (all P &lt; 0.0001), with strongest associations found amongst visceral Fat Mass Index (□□95%CI]=0.48[0.20;0.23]) and android/gynoid ratio (□[95%CI]=0.55[1.31;1.63]) with triglycerides levels. Visceral adiposity contributed 17-40% (all P &lt; 0.0001) to the variance in the associations of ethnic Malays and South-Asians with metabolic phenotypes, 3-7% higher than subcutaneous adiposity.

Conclusions
Visceral adiposity contributes to poorer metabolic phenotype in ethnic Malays and South Asians as compared to Chinese.

Key messages
Visceral adiposity expansion is an important determinant of metabolic health in Asian populations.
1442The burden of COVID-19 in Australia in 2020
Authors: Moon Lynelle , Reynolds Anna , Gourley Michelle 
Published: September 2021

Abstract

Background
During 2020, there were nearly 28,500 cases of COVID-19 in Australia. Burden of disease estimates for COVID-19 have not been calculated for the Australian population. Burden of disease data on COVID-19 provide valuable information on the impact of the disease, including both fatal and non-fatal effects.

Methods
Burden of disease is measured using the summary measure disability-adjusted life years (DALYs). One DALY is 1 year of ‘healthy life’ lost due to illness (Years Lived with Disability) and/or death (Years of Life Lost)—the more DALYs associated with a disease or injury, the greater the burden. The analysis draws on Australian deaths, incidence and severity, as well as methods and other inputs developed in other countries reflecting current understanding about this new disease.

Results
There were over 8,300 DALYs lost due to COVID-19 in 2020 in Australia; 97% of the disease burden arose from fatal cases. Males lost an average of 10.7 years, and females 8.1 years, due to dying from COVID-19, using an aspirational life expectancy. The burden of disease estimates for Australia for COVID-19 are much lower than the leading diseases causing burden.

Conclusions
The relatively low burden for COVID-19 in Australia in 2020 compared to other diseases and other countries reflects the success Australia had in containing the virus.

Key messages
Most of the burden due to COVID-19 in Australia was fatal. Burden of disease estimates for COVID-19 in Australia for 2020 are much lower than the leading diseases.
839A novel approach to investigating poor growth in a longitudinal study of infants in PNG
Authors: Moreira Clarissa , Scoullar Michelle , Peach Elizabeth , Fidelis Ruth , Melepeia Pele , Pomat William , Siba Peter , Crabb Brendan , Robinson Leanne ,   HMHB Study Team, Agius Paul , Beeson James 
Published: September 2021

Abstract

Background
Children in Papua New Guinea (PNG) experience high rates of malnutrition and poor growth - nearly half of children under 5 are stunted and 16% wasted.

Methods
We investigated predictors of infant growth over the first year of life using longitudinal data from mothers and infants in PNG. Between 2015 and 2018, 699 pregnant women were enrolled. At delivery, one, 6- and 12-months post-partum blood samples and anthropometric measurements were taken from mothers and infants. Using structural equation modelling with full information maximum likelihood, multivariate latent growth curve (LGC) modelling for infant weight and length (i.e. simultaneous estimation) was undertaken, and maternal factors that influenced growth investigated.

Results
A quadratic function for growth (weight and height) was estimated. Boys were larger at birth (49cm, 3.2kg vs. 48cm, 3.0kg; Wald χ2(2) =15.3, p&lt;0.001) and gained more weight and length monthly (Wald χ2(4) =68.4, p&lt;0.001). Maternal height, MUAC and number of antenatal healthcare visits were associated with birth weight and length, but not growth. Maternal nutrition and infections, breastfeeding and complementary feeding were not associated with birth size or growth.

Conclusions
Maternal height and MUAC and antenatal healthcare were associated with birth size and no maternal factors were associated with growth. Prenatal interventions to improve postnatal infant growth may be challenging in this environment

Key messages
Compared to conventional LGC analysis, multivariate LGC modelling using SEM provides less biased estimates of infant growth and factors associated with growth, particularly in the presence of missing data and infant-specific weight and height heterogeneity.
662Factors associated with smoking continuation and indoor smoking among pregnant women’s partners
Authors: Murakami Keiko , Obara Taku , Ishikuro Mami , Ueno Fumihiko , Noda Aoi , Kuriyama Shinichi 
Published: September 2021

Abstract

Background
Secondhand smoke by partners is a major source of exposure for non-smoking women. However, factors associated with smoking continuation and indoor smoking among pregnant women’s partners remain unknown.

Methods
We used data from 6348 partners of non-smoking pregnant women who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study in Japan from 2013 to 2017. Partners’ age, educational attainment, equivalent household income, and pregnant women’s smoking history (never, quitting before pregnancy awareness, quitting after pregnancy awareness) were used as explanatory variables. Multivariate logistic regression analyses were conducted to examine the associations between these variables and smoking continuation/indoor smoking of partners.

Results
Among 6348 partners, 2506 partners had been smokers at pregnancy awareness. Among them, the prevalence of smoking continuation after pregnancy awareness was 92.0%. Partners whose wives had quitted smoking after pregnancy awareness were less likely to continue smoking than partners whose wives had never smoked; the odds ratio was 0.57 (95% confidence interval, 0.41–0.80). Among partners who continued smoking, the prevalence of indoor smoking was 30.7%. Partners with ≤high school education were more likely to smoke indoors than partners with ≥university education; the odds ratio was 1.60 (95% confidence interval, 1.23–2.07).

Conclusions
Women’s smoking cessation after pregnancy awareness was associated with decreased risk of partners’ smoking continuation, and lower level of partners’ education was associated with increased risk of partners’ indoor smoking.

Key messages
Interventions for both women and their partners may be effective in reducing secondhand smoke exposure during pregnancy.
1396Trends in household food expenditure patterns by ethnic and income group in New Zealand
Authors: Nghiem Nhung , Teng Andrea , Cleghorn Cristina , Wilson Nick 
Published: September 2021

Abstract

Background
Dietary factors are one of the most important risk factors for health loss worldwide, however there is very limited information on dietary trends in New Zealand (NZ) and whether inequities in dietary patterns are changing.

Methods
We employed a validated economic dataset, the Household Economic Survey (HES), which was designed to provide information on impacts of policy-making in NZ. Three HES waves in 2006/07, 2009/10 and 2012/13 (n = 9030) were used to examine the trends in household expenditure for key food groups by income-level and ethnicity.

Results
Overall, food expenditure per capita increased by 1% annually. In absolute terms, low-income households spent around half that of high-income households on food, but with no relative differences out of the total food expenditure or income. Māori households (Indigenous population) tended to spend less money compared to the other households, both in absolute and relative terms (ie, on healthy food including fruit and vegetables, and nuts and seeds, but with relatively more expenditure on processed meats). Similar food expenditure patterns by income-level and ethnicity persisted over time.

Conclusions
HES data were useful for understanding trends in food expenditure patterns, in the absence of nutrition survey data, but limitations remain. Assuming food consumption is highly correlated to expenditure, diet inequities do not seem to have improved during this recent time period.

Key messages
Public policies that aim to support healthy diets for all might need to involve changes to the food environment and involve government support for culturally appropriate Māori-led interventions.
134Trends and projections of Treatment as Prevention strategy in Africa and progress towards UNAIDS targets
Authors: Nguyen Phuong , Le Phuong , Onishi Kazunari , Nguyen Huy , Gilmour Stuart 
Published: September 2021

Abstract

Background
Africa is lagging behind in progress toward global HIV/AIDS elimination targets. We estimated trends in and projections of annual HIV testing and condom use at last higher-risk sex; and calculated the probability of reaching key UNAIDS’s target.

Methods
We included 114 nationally-representative datasets in 38 African countries from DHS and MICS with 1456224 sexually active adults age 15-49 from 2003 to 2018. We applied Bayesian mixed effect models to estimate the coverage of annual HIV testing and condom use at last higher-risk sex for every country and year to 2030; and the probability of reaching UNAIDS testing and condom use targets of 95% coverage by 2030.

Results
Seven countries saw downward trends in annual HIV testing and four saw decreases in condom use at higher-risk sex, while most countries have upward trends in both indicators. The highest coverages of testing in 2030 are predicted in Swaziland, Uganda and Lesotho. Meanwhile, Swaziland, Lesotho, and Namibia will have the highest proportion of condom use in 2030. The probabilities of reaching targets were very low for both HIV testing (0%-28.5%) and condom use (0%-12.1%).

Conclusions
We observed limited progress on annual HIV testing and condom use at last higher-risk sex in Africa, and little prospect of reaching global targets for HIV/AIDS elimination.

Key messages
Although some global sponsor agencies are considering withdrawal from supporting Africa, more considerable attention to funding and expanding testing and treatment are needed if HIV/AIDS elimination in Africa is to become more than a distant dream.
1347Mental health status of health care workers during the COVID-19 outbreak: An International Study
Authors: Nicolaou Christiana , Menikou Joanna , Gloster Andrew , Karekla Maria , Kassianos Angelos 
Published: September 2021

Abstract

Background
The COVID-19 pandemic is a massive health crisis affecting our planet, with over 166,346,635 confirmed cases and 3,449,117 deaths globally till 24 May 2021. The COVID-19 pandemic is a massive health crisis which has brought enormous physical and psychological pressure. Mental health care for health care workers (HCWs), should receive serious consideration. The aim of this study was to determine mental health outcomes of HCWs and to examine known predictors of outcomes during the first pandemic wave.

Methods
1,556 HCWs who participated in the COVID-19 IMPACT project, an international online survey examining the behavioral and psychological impacts of COVID-19 among 9,565 people from 78 countries/regions and 18 languages. Outcomes assessed were stress, depression symptoms and sleep changes. Predictors examined included sociodemographic factors, and perceived social support.

Results
Results demonstrated that, half of the HCWs had moderate levels of perceived stress and depression symptoms. Predictors associated with higher HCWs’ stress and depression symptoms included female gender, not having children, living with parents, lower educational background and having lower social support. Half of the HCWs (n = 800, 51.4%) continued to sleep about the same and one in four slept more or slept less. Positive predictors of sleep changes were being older, widower, not working, living with parents, and having children. Surprisingly, HCWs had less perceived stress and depression and higher levels of perceived social support than the general population.

Conclusions
The need for establishing ways to mitigate mental health risks and adjust psychological intervention and support of HCWs, seems to be significant as the pandemic continues.
Keywords: health care workers, COVID – 19, pandemic, mental health, psychological problems
1002Job insecurity and health-related quality of life - a cross-sectional study in Sweden
Authors: Norström Fredrik 
Published: September 2021

Abstract

Background
Research shows that concern about job loss impacts negatively on health. However, no studies have examined how job loss affects health-related quality of life. The aim of this study is to examine how job insecurity affects health-related quality of life among Swedish employees.

Methods
The sample comprised 967 participants (39%) out of 2,500 randomly selected individuals. They answered a questionnaire that included a question about the risk of involuntary unemployment during the following three years and the EuroQol 5 dimensions (EQ-5D) instrument. EQ-5D responses were translated to a quality-adjusted life year (QALY) score with anchor points 1 (perfect health) and 0 (death). Of employed respondents without recent unemployment, 83 considered themselves to have at least some risk of unemployment, while 602 felt at most a small risk of unemployment. Inverse probability-weighted propensity scores were used in the analyses to estimate a risk difference. Gender, age, education level, marital status, and previous health were included as covariates.

Results
There was a statistically significant lower QALY score by 0.068 points for those with job insecurity compared with those without job insecurity. There were also statistically significantly more problems due to job insecurity for usual activities (9.5% more), pain/discomfort (13.3% more), anxiety/depression (16.6% more), and EQ-5D’s Visual Analogue Scale (4.5 point lower score).

Conclusions
There was a strong indication that job insecurity affects health-related quality of life. Further studies are needed to better understand how job insecurity affects health.

Key messages
More stable job positions should be prioritized by policy makers.
1148Determinants of adherence to clinic appointments among Tuberculosis and HIV co-infected individuals, Johannesburg, South Africa
Authors: Nhandara Ruvimbo , Ayele Birhanu , Ozougwu Lovelyn , Sigwadhi Lovemore , Nyasulu Peter 
Published: September 2021

Abstract

Background
Tuberculosis (TB) is one of the leading cause of morbidity and mortality among people living with HIV/AIDS. The growing burden of TB/HIV co-infection continues to strain the healthcare system due to association with long duration of treatment. This is a catalyst for poor treatment adherence, which is a major public health challenge due to its propensity to drive drug resistance. This study evaluated the effects of treatment duration on adherence to treatment among TB/HIV co-infected patients.

Method
This was a cross sectional study that involved 10427 patients’ ≥18 years of age with HIV infection and co-infected with TB. We measure adherence to clinic appointments as ’good’ if ≥ 90% and poor if &lt; 90%. We used multivariate logistic regression to evaluate factors associated with adherence to clinic appointments.

Results
1528 patients were co-infected with TB, of these 17.4% of them attained good adherence to clinic appointments. Patients with TB/HIV co-infection who were on treatment for a longer period were less likely to adhere to clinic appointments (AOR: 0.98 95% CI: 0.97, 0.99). This confirms the notion that advanced disease has a negative impact on adherence to clinic attendance for follow up reviews.

Conclusions
Duration on treatment among TB/HIV co-infected patients is associated with treatment adherence. It is therefore vital to reinforce public health intervention that would enhance sustained treatment adherence and mitigate its impact on development of drug resistance.
664ICT use and participation in community support activities among the elderly in Japan
Authors: Ohta Akiko , Nishina Motoko , Motohashi Chiemi , INoue Naoko , Miyazaki Takashi , Takahashi Mihoko , Uemura Makiko , Kamei Midori 
Published: September 2021

Abstract

Background
Text: Information and Communication Technology (ICT) use has penetrated the daily lives of individuals as well as the activities of public organizations. We examined the cross-sectional association between ICT use and participation in community support activities in the elderly aged 65-74 for building community social capital in the current active aging policy of Japan.

Methods
Text: The target population was all residents aged 65-74 years without disabilities in a municipality, Japan. The self-administered questionnaires were mailed to 5,163 individuals in 2018. A Total of 2,283 persons responded (response rate, 44.2%). Participants provided information on basic characteristics, ICT use, and intention to participate in community support activities for the elderly.

Results
Text: A total of 1,089 (47.7%) persons showed positive intention to participate in community support activities for the elderly. Respondents who used a smartphone daily were 768 (33.6%). The proportion of participants with positive intention to participate in community support activities was 55.9% for those who used smartphones daily, whereas 42.8% for those who did not. Respondents who used the website, LINE, or QR codes were more likely to participate in community support activities than those who did not.

Conclusions
Text: Elderly people who utilize ICT frequently were more likely to participate in community support activities. ICT use among the elderly may be useful for building relationships of mutual assistance in the community.

Key messages
Text: ICT helps mutual assistance among the elderly in communities.