bluuebunny/crossref_metadata_2025_split huggingface dataset:
1494Content Analysis and Predicting Survey Refusal: What Are Respondents’ Concerns about Face-to-face Mental Health Survey?
Authors: Altwaijri Yasmin 
Published: September 2021

Abstract

Background
Previous studies suggest that refusals form the largest proportion of nonresponse for household surveys. As face-to-face household health surveys are uncommon in several countries, it might be advantageous for prospective surveys to preemptively tackle respondents’ refusal to survey participation.

Methods
Using contact history data from the Saudi National Mental Health Survey, we examined the relationship between social environmental factors, respondent characteristics, survey request concerns recorded by interviewers, and respondents’ propensity to refuse to participate in the survey. Content analysis and logistic regressions were conducted.

Results
Our findings suggest that urbanicity, region, socioeconomic status, age, and gender are associated with refusal. Patriarchal gatekeepers and specific survey-related concerns are more likely to lead to temporary refusals compared to final refusals.

Conclusions
These results have implications for survey researchers employing similar recruitment and data collection methods, for example in tailoring refusal conversion strategies for interviewers to address concerns expressed by Saudi and/or culturally similar respondents.

Key messages
Results might benefit studies considering similar methods and investigating sensitive issues, improve response rates, and combat the declining trend that potentially jeopardizes the quality of survey data collected.
513Ophthalmic disease and older adults’ sedentary and physically-active behaviors: Findings from the NEIGE study
Authors: Amagasa Shiho , Inoue Shigeru , Murayama Hiroshi , Fujiwara Takeo , Kikuchi Hiroyuki , Fukushima Noritoshi , Machida Masaki , Chastin Sebastien , Owen Neville , Shobugawa Yugo 
Published: September 2021

Abstract

Background
Physical inactivity can be associated adversely with markers of eye health, but little is known about how ophthalmic disease (OD) may be related to sedentary behaviour (SB) and different intensities of physical activity in older adults. We compared device-assessed time spent in SB, light-intensity PA (LPA), and moderate-to-vigorous physical activity (MVPA) between older adults with and without OD.

Methods
A randomly-recruited sample of 512 community-dwelling older adults (47% male; aged 65–84 years) in Japan wore a valid tri-axial accelerometer for seven consecutive days in 2017. Prevalence of OD was assessed by medical interview. Times spent in SB, LPA, and MVPA were compared between those with and without OD by compositional multivariate analysis of covariance, adjusting for potential confounders (gender, age, residential area, living arrangement, working, body mass index, self-rated health, and cognitive function).

Results
Overall, percent times spent in SB, LPA, and MVPA during waking hours were 51.0, 44.6, and 4.4, respectively; and, 167 (36.5%) had OD. Activity patterns differed significantly between those with and without OD: in those with OD, the proportion of time spent in MVPA relative to other behaviours was lower, and the proportion of time spent in SB relative to other behaviours was higher.

Conclusions
Older adults with OD were found to be less physically active than those without.

Key messages
While these cross-sectional findings need to be confirmed by evidence from prospective studies, the reciprocal influences of OD and inactivity in older adults should be addressed as scientific, clinical and public health considerations.
1058Association between loneliness and residential green space: a longitudinal study of Australian adults
Authors: Astell-burt Thomas , Feng Xiaoqi 
Published: September 2021

Abstract

Background
Loneliness, a condition associated with premature death, is estimated to affect 1 in 4 Australian adults. Evidence to inform public policy responses is needed. The UK’s loneliness strategy suggested more green space is part of the solution, based on cross-sectional evidence.

Methods
Association between incident loneliness over five years with respect to residential green space exposure within 1600m, 800m and 400m was assessed using multilevel models adjusting for potential socioeconomic and demographic confounders. The sample was restricted to adults living in major cities in Australia who did not report feeling lonely at baseline.

Results
Incidence of loneliness was 12% (820/6017) in a sample with a mean age of 44 (range 15-93), 53% female. Adjusting for age and gender, lower odds of incident loneliness were reported in areas with 10% higher green space provision within 1600m (OR = 0.90, 95%CI 0.83-0.96) and within 800m (0.93, 0.88-0.99), but not within 400m. Adjustment for income, education, couple status, ancestry and children attenuated association with green space within 800m, but association with green space within 1600m remained (0.90, 0.85-0.97). This association also remained after adjustment for neighbourhood disadvantage and personality traits and was stronger for people living on their own.

Conclusions
The odds of incident loneliness appear lower among adults with more green space within 1600m

Key messages
Strategies to increase green space provision within 1600m in cities may support prevention of loneliness in adults and especially those living on their own.
600Homelessness in Hamilton, New Zealand: debt as a tipping point?
Authors:   Polly Atatoa Carr, Whitehead Jesse , McMinn Carole 
Published: September 2021

Abstract

Background
The People’s Project (TPP) in Hamilton, NZ takes a Housing First approach to eliminate homelessness. A recent research collaboration provides epidemiological evidence regarding: the people served through TPP; their service engagement; pathways into homelessness; and lost opportunities for early intervention.

Methods
Data has been collected from a total of 755 TPP participants, including those from client registrations (July 2015-March 2017; n = 695) and a ‘pathways into homelessness’ questionnaire implemented in 2019. All participants were asked questions regarding their experiences of debt, levels of debt and the specific agencies and debtors involved.

Results
Common pathways into homelessness included individual factors (e.g. substance dependencies, family breakdown), structural factors (lack of suitable and accessible housing, deinstitutionalisation, service failures), and poverty exacerbated by debt. Of this cohort, 62% described current debt, and $2.8million (NZD) of debt was estimated (average of $10000 per person). Debts to government agencies were common and significant, including to Work and Income NZ, student loans, court costs and Housing NZ.

Conclusions
Financial difficulty, and particularly debt, is an important tipping point into homelessness. High levels of debt exclude people from permanent housing and challenge policies and practices aiming to end homelessness. Furthermore, debt to government agencies - required to invest in homelessness prevention and support - is a systems and policy failure.

Key messages
Financial difficulties, specifically debt, and systems failures are important tipping points for vulnerable populations into homelessness
Debts owed to government agencies by the homeless population provide an opportunity to reorient the system to support homelessness prevention.
599RCT of Harti Hauora Tamariki: a holistic family-centred programme for child health and equity
Authors:   Polly Atatoa Carr, Scott Nina , Jones Amy , Masters-Awatere Bridgette , Sandiford Peter 
Published: September 2021

Abstract

Background
In Aotearoa NZ, preventable paediatric admissions and readmissions with diseases of poverty are common, particularly for Māori (Indigenous) children. In response, the Harti Hauora Tamariki (HHT) was developed. This is a multilevel programme of: culturally safe engagement; comprehensive high-quality screening; standardised evidence-based protocols for addressing need(s) and navigation. Methodological innovations are required for a RCT of HHT effectiveness within the context of whānau (family) wellbeing.

Methods
Approximately 980 children admitted to paediatrics at Waikato Hospital were randomised (with whānau) to HHT or usual care. Measures of effectiveness include: level of unmet need identified; impact of HHT on meeting needs; qualitative assessment of HHT support for health outcomes and whānau satisfaction with care. The primary quantitative endpoint is relative readmission risk.

Results
Qualitative case studies demonstrate the importance of engagement and the high-trust environment of HHT enabling whānau to reveal needs. Needs are common. Many needs identified (such as food insecurity, lack of resources) are not recognised through standard hospital care. HHT adaptations were required. Quantitative outcome analyses are underway.

Conclusions
The whole health system has responsibility and ability to improve whānau health promotion, prevention, and wellbeing support. HHT provides a model for action. RCT assessment of HHT needed to be whānau-centred and flexible to match programme evolution and provide evidence for effectiveness.

Key messages
A family-centred holistic screening programme, with culturally-safe engagement, improves inpatient care and enhances determinants of health.
Indigenous leadership and commitment to Indigenous wellbeing and equity facilitates effective programme improvement, within an adaptable RCT framework.
1345Uptake of Intermittent Preventive Treatment for malaria during pregnancy with Sulphadoxine-Pyrimethamine in Malawi
Authors: Azizi Steven 
Published: September 2021

Abstract

Background
This study aimed to estimate the proportion of and identify factors associated with uptake of ≥ 3 doses of Intermittent preventive treatment of malaria during pregnancy with sulphadoxine-pyrimethamine (IPTp-SP) among pregnant women in Malawi after adoption of the 2012 updated WHO IPTp-SP policy.

Methods
The 2015–16 Malawi Demographic and Health Survey dataset was re-analysed. Only 1069 women were included in the analysis from 1219 women who had live births, born after July 2015. Logistic regression was used in data analysis considering complex survey sample design.

Results
Of the 1069 women, 447 (42%) received ≥3 doses (optimal) of IPTp-SP, while 47% managed to attend ≥4 antenatal care (ANC) clinics. Only 52% received optimal SP doses among those who made ≥4 ANC visits. The number of ANC visits was associated with the optimal uptake of SP. Women who attended ANC three times only and those who visited ANC at most twice were less likely to receive optimal doses than those who managed to attend ANC ≥4 times during pregnancy (AOR = 0.71, 95% CI 0.49–1.02) and (AOR = 0.12, 95% CI 0.06–0.21) respectively.

Conclusions
There is low uptake of optimal SP doses in Malawi. This seems to be associated with the number of ANC visits. However, there is limited effectiveness of increased number of ANC visits on the uptake of optimal SP doses.

Key messages
Increased number of ANC visits is not enough to increase uptake of optimal doses of IPTp-SP. There is need for continued and varied efforts.
638Reporting of gestational diabetes and chronic conditions of pregnancy: validation of routinely collected hospital data
Authors: Baldwin Heather , Torvaldsen Siranda , Rickard Kristen , Nippita Tanya , Patterson Jillian 
Published: September 2021

Abstract

Background
Gestational diabetes, hypertension, thyroid conditions and morbid obesity in pregnancy are associated with increased risks of adverse outcomes. Hospital data are important for research on these conditions, however, up-to-date validation of reporting is needed to understand the extent to which the data reflect the clinical situation.

Methods
Women giving birth to singleton infants in two tertiary hospitals in New South Wales, Australia, between 2011 and 2015 were included. Obstetric data, from the ObstetriX system, was used as the gold standard to which linked hospital data, from the Electronic Medical Record, were compared.

Results
There were 35,928 births included. Gestational and pre-existing diabetes had high sensitivity (83.6% and 88.2%) and positive predictive values (PPV, 92.7% and 86.0%). Pre-eclampsia and eclampsia, gestational hypertension and any hypertension had good sensitivity (80.0%, 80.1%, 81.5%), but moderate PPVs (59.7%, 65.6%, 70.4%), while for chronic hypertension sensitivity (53.5%) and PPV (53.2%) were lower. Obesity and thyroid conditions showed low sensitivity (9.8%, 12.9%; PPV 65.6%, 82.3%). Specificity and NPV were high for all conditions.

Conclusions
We found reliable reporting of gestational diabetes, pre-existing diabetes and all types hypertension, except for chronic hypertension which was moderately well reported. Thyroid conditions and morbid obesity were very poorly reported.

Key messages
Diabetes appears well reported in the hospital data, and sensitivity for hypertension may be improved by using a grouped category. Hospital data on thyroid conditions and obesity should be used with caution.
713Domestic violence and self-poisoning in Sri Lanka
Authors: Bandara Piumee , Page Andrew , Senarathna Lalith , Kidger Judi , Feder Gene , Gunnell David , Rajapakse Thilini , Knipe Duleeka 
Published: September 2021

Abstract

Background
There is increasing evidence that domestic violence is an important risk factor for suicidal behaviour. The level of risk of domestic violence (DV) and its contribution to the overall burden of suicidal behaviour has not been quantified in South Asia, where 37% of suicide deaths globally occur. We examined the association between DV and self-poisoning in Sri Lanka through a large case-control study.

Methods
Multivariable logistic regression models were conducted on 298 self-poisoning cases and 500 hospital controls to estimate the association between domestic violence and self-poisoning, and population attributable fractions (PAF) were estimated. Sensitivity analyses were conducted using 455 population-based controls.

Results
DV exposure within the previous 12 months was strongly associated with self-poisoning for women (adjusted OR [AOR] 4·08, 95%CI 1·60-4·78) and men (AOR 2·52, 95%CI 1·51-4·21), compared to no abuse. Physical violence showed the highest risk among women, whereas among men, emotional abuse showed the highest risk (AOR 2·75, 95%CI 1·57-4·82). PAF% for exposure to at least one type of DV was 38% (95%CI 32-43) in women and 22% (95 CI 14-29) in men.

Conclusions
DV was strongly associated with suicidal behaviour for men and women. Almost 40% of female self-poisoning cases and a fifth of male cases may be reduced if domestic violence is addressed.

Key messages
The significant contribution of DV to the overall burden of self-poisoning suggests preventative and curative interventions to address domestic violence may yield significant gains in reducing suicidal behaviour in Sri Lanka, and other similar settings.
1528Prospective Vs Retrospective Cohort Studies: Is a Consensus Needed?
Authors: Bashir Maryam Mohammed , Maskari Fatma Al , Ahmed Luai , Al-Rifai Rami H. 
Published: September 2021

Abstract

Focus of Presentation
There is a confusion among epidemiologists, especially early-career epidemiologists, on the different definitions and use of prospective and retrospective cohort studies. There is a need for consensus by the expert community on this methodological dilemma.

Findings
Different Epidemiology experts define prospective and retrospective cohort studies differently. Most textbooks define prospective cohort study as one conducted when all the subjects are outcome-free while in retrospective cohort study, at least some of them have developed the outcomes, then researchers go back in time to study exposures. However, some experts define both study types based on the time of development of the research hypothesis or question in relation to data collection.
Some experts consider retrospective studies to be only from records. Meanwhile, some consider any follow up study to be prospective even if historical data is used.
These disparities in definitions lead to confusion among young epidemiologists. Some experts state that there is no need to differentiate between the two studies, however, we are aware of the possible bias and confounding that could occur from retrospective studies.

Conclusions/Implications
It has become essential for the expert community to address this methodological dilemma and to reach consensus on it. This could serve as a guide for young epidemiologists and ensure the uniformity of research worldwide.

Key messages
There are disparities in definitions and use of prospective and retrospective cohort studies. Hence, the expert community, especially the International Association of Epidemiology, should address this dilemma and reach a consensus to form standard guidelines.
797Understanding bias in recruitment through population-based cancer registries
Authors: Bergin Rebecca , White Vicki , English Dallas , Milne Roger 
Published: September 2021

Abstract

Focus of Presentation
Participant recruitment through registries can provide population-based samples, but there are methodological challenges. We examine challenges and solutions in two studies recruiting participants through the Victorian Cancer Registry. Cross-sectional surveys of patients with colorectal, lung or ovarian cancer conducted in 2013-14 (study 1) and repeated in an ongoing study (study 2). The registry managed fast-track recruitment of eligible patients ( &gt; =40yrs, confirmed diagnosis, approached within 6-months of diagnosis)

Findings
In study 1, registry rules for confirmed diagnosis required surgical histopathology. For cancers primarily treated non-surgically (e.g. lung), selection bias was common. In study 2, confirmation rules were extended to include biopsies with subsequent hospital notification.
The registry does not receive imaging notifications and pathology labs/hospital reports can be delayed (&gt;60days). Study eligibility criteria meant cases with advanced disease, common in lung cancer, or without a confirmed diagnosis within the study timeframe were excluded. However, colorectal and ovarian cases in study 1 were largely representative of the eligible population.
In study 2, a different fast-track recruitment approach meant a longer time from diagnosis to response compared to study 1 (median 7 vs 5 months). Recruitment procedures are being improved through engagement between researchers and registry.

Conclusions/Implications
Local registry-based rules for recruitment and available data, study eligibility criteria and cancer type (particularly cancers without histopathological confirmation), may introduce bias. Researchers need to work closely with registry colleagues to understand and optimise recruitment.

Key messages
Registry-based recruitment can be biased. Early and ongoing communication between researchers and registry is strongly recommended.
937Rasch analysis of the Health Literacy Questionnaire in the Understanding Multiple Sclerosis online course cohort
Authors: Bessing Barnabas , Honan Cynthia A. , van der Mei Ingrid , Taylor Bruce. B , Claflin Suzi B. 
Published: September 2021

Abstract

Background
We have built a six-week free online course to improve multiple sclerosis (MS)-related knowledge, health literacy (HL), and resilience among members of the MS community and interested laypeople, entitled Understanding MS. To evaluate the effectiveness of the course, we require an appropriate tool to measure HL in this cohort.

Objective
To evaluate the psychometric properties of the multidimensional Health Literacy Questionnaire (HLQ) in a cohort of Understanding MS online course enrolees.

Methods
Participants who enrolled in the first two open enrolments of the Understanding MS online course completed the HLQ (n = 1182) in an online survey prior to beginning course materials. We used Rasch analysis to assess the measurement properties of the HLQ.

Results
The nine subscales of the HLQ each had a good fit with the Rasch model; they were unidimensional, had good internal consistency and reliability and no item bias or local dependency measurement gaps were identified for participants with low or high scores in each of the nine subscales, creating a ceiling effect, meaning that the HLQ cannot reliably measure change in HL over time for these participants. The HLQ is a reliable measurement tool to assess change in HL for people with low to moderate HL levels who have room to improve, which is our target group.

Conclusion
The HLQ is useful for assessing HL in this and similar cohorts, but the assessment of HL change should consider the limitations described above.

Key messages
The HLQ has excellent measurement properties and is appropriate for assessing HL
970Comparison of lab-and non-lab based absolute cardiovascular disease risk scores in rural India
Authors: Birhanu Mulugeta Molla , Evans Roger G. , Zengin Ayse , Riddell Michaela A , Kalyanram Kartik , Kartik Kamakshi , Suresh Oduru , Thomas Nihal , Srikanth Velandai K. , Thrift Amanda G. 
Published: September 2021

Abstract

Background
Over 75% of global cardiovascular (CVD) deaths occur in low-to-middle-income countries (LMICs).
In limited resource settings non-lab-based CVD risk algorithms could be as effective as lab-based algorithms in identifying high-risk groups. We aimed to compare the concordance between lab-and non-lab-based absolute CVD risk algorithms in a LMIC setting.

Methods
The study was conducted in the Rishi Valley, Andhra Pradesh, India. Over 8,000 participants were surveyed between 2012-2015. The 10-year absolute CVD risk score was computed and compared using lab-and-non-lab based Framingham and WHO algorithms.

Results
In participants aged 35-74 years, absolute CVD risk score increased with age, and was greater in men than women, for all risk assessment tools. Using the Framingham lab-based algorithm, 15.6% were categorized as high-risk while 14.5% were at high-risk using the non-lab-based algorithm. The non-lab-based Framingham risk score had close agreement and strong correlation with the lab-based Framingham risk score in women (90%, Spearman’s rho (rs)=0.81) and men (83%, rs=0.89). Similarly, the non-lab-based WHO risk score had close agreement and strong correlation with the lab-based WHO risk score in women (95%, rs=0.83) and men (92% rs=0.84). In both cases, agreement was better in women than men (P &lt; 0.05 for a two-sample test of proportions).

Conclusions
The effectiveness of non-lab-based Framingham and WHO algorithms are comparable to that of lab-based algorithms in discriminating high-and low-risk groups. However, the performance of non-lab-based risk score is better among women than men.

Key messages
Non-lab-based CVD risk algorithms could be effective and resource-efficient in LMIC settings, particularly among women.