bluuebunny/crossref_metadata_2025_split huggingface dataset:
863Alcohol and cancer in an Australian cohort of 226,162 participants aged 45 years and over
Authors: Sarich Peter , Canfell Karen , Egger Sam , Banks Emily , Joshy Grace , Grogan Paul , Beral Valerie , Weber Marianne 
Published: September 2021

Abstract

Background
Australia has a relatively high level of alcohol consumption. Although alcohol consumption is known to increase the risk of several cancer types internationally, local evidence for Australia is limited.

Methods
Cox proportional hazards regressions were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for cancer risk in relation to weekly alcohol consumption among 226,162 participants aged ≥45 years (2006-2009) in the 45 and Up Study, an Australian prospective cohort study. Incident cancer cases were ascertained by linkage to the New South Wales Cancer Registry to December 2013 by the Centre for Health Record Linkage.

Results
Over a median 5.4 years, 17,332 cancers were diagnosed. Increasing levels of alcohol intake were associated with increased risk of any cancer (HR per seven drink increase in weekly consumption: 1.02; 95% CI: 1.00-1.04), and cancers of the upper aerodigestive tract (1.19;1.10-1.29), mouth/pharynx (1.18;1.08-1.29), oesophagus (1.22;1.04-1.43), colorectum (1.09;1.04-1.15), colon (1.13;1.06-1.20), liver (1.22;1.04-1.44), breast (1.09;1.00-1.18), and melanoma (1.05;1.00-1.10); whereas an inverse association was observed for thyroid cancer (0.80;0.64-1.00). We estimated that by age 85 years, Australian men and women who consume &gt;14 drinks/week increase their absolute risk of alcohol-attributable cancer by 4.4% and 5.4%, respectively, compared to non-drinkers.

Conclusions
We report relative risks of cancer incidence in relation to alcohol consumption that match the international evidence. In Australia, a nation with relatively high alcohol consumption, these risks may translate into a significant public health burden.

Key messages
We have generated estimates for the relationship between alcohol consumption and cancer risk in Australia.
874Impact of overweight on diabetes prevalence: 20-year trends in National Health and Nutrition Survey, Japan
Authors: Sata Mizuki , Sugiyama Daisuke , Hirata Takumi , Horie Saki , Takimoto Hidemi , Okamura Tomonori 
Published: September 2021

Abstract

Background
Increasing trend of diabetes is significant public health threats. This is a consecutive cross-sectional study aimed to estimate the attribution of overweight for diabetes prevalence in Japan.

Methods
We used individual data aged 20 years and older of National Health and Nutrition Survey in 1997 (2349 men and 3588 women), 2002 (2075 and 3087), 2007 (1614 and 2346), 2012 (5538 and 7981), and 2016 (4327 and 6270). Diabetes was defined as glycated haemoglobin (HbA1c) &gt;6.5% or currently being treated. We estimated multivariable-adjusted odds ratio (OR) and 95% confidence interval (CI) for the association between diabetes and overweight (body mass index &gt;25kg/m2) after adjusting for the number of steps per day, total energy intake (kcal/kg), fat energy ratio (%), smoking and drinking status by logistic regression.

Results
There was significant association between diabetes and overweight in all years: multivariable-adjusted OR (95%CI) were 1.78 (1.32-2.40) in 1997, 1.46 (1.10-1.93) in 2002, 1.77 (1.35-2.32) in 2007, 1.79 (1.55-2.07) in 2012, and 2.15 (1.82-2.54) in 2016 for men and 2.53 (1.92-3.32), 2.53 (1.87-3.42), 2.91 (2.15-3.95), 2.94 (2.51-3.45), and 2.72 (2.27-3.25), for women, respectively. The estimated population attribution on diabetes prevalence due to overweight was 14.8%, 11.9%, 18.1%, 18.0%, and 24.6% for men and 27.0%, 29.4%, 29.9%, 29.5%, and 26.7% for women.

Conclusions
Overweight was a risk factor for diabetes consistently for 20 years. That attribution was increasing among men but decreasing after peaking in 2007 among women.

Key messages
The present study suggested a high burden of diabetes due to overweight in Japan.
1161Educational level, attention problems, and externalizing behaviour in adolescence – Social causation versus health-related selection
Authors: Schmengler Heiko , Peeters Margot , Stevens Gonneke W.J.M. , Kunst Anton E. , Hartman Catharina A. , Oldehinkel Albertine J. , Vollebergh Wilma A.M. 
Published: September 2021

Abstract

Background
Social causation and health-related selection may contribute to educational gradients in adolescents’ attention problems (AP) and externalizing behaviour (EB). From past studies it is unclear which of these mechanisms predominates, as AP and EB have the potential to interfere with educational performance, but may also be affected by differences in the educational context. Furthermore, gradients in AP and EB may reflect confounding by stable background characteristics, which are often unmeasured (e.g. genetics). We investigated social causation and health-related selection in the development of educational differences in EB and AP.

Methods
We used data from a Dutch population-based cohort (TRAILS Study; n = 2,229), including measurements of educational level, EB, and AP at ages around 14, 16, 19, 22, and 26 years. We employed cross-lagged panel models with fixed effects. This novel method allowed to evaluate the directionality in longitudinal associations between education, EB, and AP, whilst simultaneously controlling for time-stable individual differences.

Results
AP, but not EB, consistently predicted decreases in subsequent educational level throughout all of adolescence and young adulthood. Regarding social causation, only lower education around age 14 predicted increases in AP around age 16, though this effect was not robust in sensitivity analyses.

Conclusions
AP interfere with educational performance and have the potential to negatively affect adolescents’ educational attainment throughout all phases of adolescence and young adulthood.

Key messages
Interventions to address the impact of AP on education are necessary in all age groups. Hereby, it is important to take developmental differences into account.
1462Second hand smoke exposure in pregnant women in Dehradun, Uttrakhand: A Cross Sectional Study
Authors: Sharma Twinkle 
Published: September 2021

Abstract

Focus of Presentation
Tobacco has always been a major public health issue. Being tobacco a major risk factor for so many diseases, it has also become a matter of concern in current situation of the pandemic. Tobacco smoking is not only harmful for the person who is actively smoking but also to ones who are in the vicinity of that smoke. There is plenty of evidence regarding harmful effects of both tobacco and inhaling tobacco smoke passively. This passive smoke is known as Second Hand Smoke.
The aim of the study was to estimate percentage and sources of Second Hand Smoke exposure among pregnant women. It was a cross sectional study conducted among pregnant women registered at a Primary health centre.

Findings
Out of total participants, 62% were exposed to Second hand smoke. 33% participants were exposed to SHS at home only, 24% at public places only and 5 % were the one exposed both at home and public places. More than half (69%) of the participants were having inadequate knowledge about the harms caused by Second hand smoke

Conclusions/Implications
More than half of the participants were exposed to Second hand smoke. Inadequate knowledge among the participants about adverse effects of SHS exposure and insufficient

Key messages
Smoke-free homes should be promoted and health-care providers should ask pregnant women about their exposure to SHS and inform about the harms of SHS exposure during anti natal visits.
1323Trends in the incidence rates of keratinocyte carcinomas from 1978 to 2018 in Tasmania, Australia
Authors: Ragaini Bruna , Blizzard Leigh , Newman Leah , Stokes Brian , Albion Tim , Venn Alison 
Published: September 2021

Abstract

Background
Keratinocyte carcinomas (KCs), namely basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), are the most common cancers in Australia. We describe trends in the incidence of KCs in the state of Tasmania over 41 years.

Methods
We identified histologically confirmed KCs within the Tasmanian Cancer Registry. Age-standardised incidence rates were calculated for first (1985-2018) and annual KCs (1978-2018). Average annual percentage changes were computed using Joinpoint regression models.

Results
A total of 83,536 people were registered with a KC between 1978 and 2018. Age-standardised incidence rates of first KCs increased on average by 3% per annum for BCCs and 4% per annum for SCCs, reaching 363/100,000 and 249/100,000 in 2018, respectively. Age-standardised incidence rates of annual KCs increased on average by 5% per annum for BCCs and 6% per annum for SCCs, up to 891/100,000 and 514/100,000 in 2018, respectively. This increase was steeper for females than males and highest during the late 1980s and early 1990s. A change in trend around 2014 suggested that incidence rates have started to decline.

Conclusions
While the incidence of KCs in Tasmania increased substantially since 1978, it has recently plateaued and started to decline. The findings may reflect changes in sun exposure behaviours due to awareness campaigns.

Key messages
Incidence of KCs has increased in 41 years and despite a recent plateau and decline, KCs still pose a substantial burden to the Tasmanian population.
102Assessing the characteristics of health state utilities among people living with multiple sclerosis
Authors: Campbell Julie , Jelinek George , Weiland Tracey , Nag Nupur , Neate Sandra , Palmer Andrew , Mulhern Brendan , Livera Alysha De , Simpson-Yap Steve 
Published: September 2021

Abstract

Background
While many studies have examined the impacts of multiple sclerosis (MS) on health-related quality-of-life (HRQoL), none have used the SF-6D multi-attribute utility instrument in a large international cohort (&gt;2,000 subjects) of people with MS. Our objective was to derive SF-6D health state utilities (HSUs) for participants of the HOLISM international cohort and to describe the distribution and determinants thereof.

Methods
HSUs were generated using the SF-6D for the Version-1 United States SF-36 for participants with sufficient SF-36 data (n = 2,185/2,466 (88.6%)). Determinants of HSU were evaluated by linear regression, adjusted for age, sex, MS type, disability (Patient-Determined MS Severity Scale), fatigue (Fatigue Severity Scale), and prescription antidepressant use.

Results
Mean HSU for the sample was 0.67 (SD = 0.13) and diminished with increasing MS-related disability. These findings were robust to adjustment, supporting the SF-6D’s discriminatory power in people with MS. Severe disability and clinically significant fatigue were each associated with 11%-lower HSU (95%CI=-0.13,-0.10 & -0.12,-0.10), and depression risk (Patient Health Questionnaire-2) with 10%-lower HSU (95%CI=-0.11,-0.08). Employment, higher socioeconomic and married/partnered statuses, larger social-network size, greater physical activity, vitamin D and omega-3 supplementations were associated with significantly higher HSU, and overweight/obese BMI and tobacco smoking with lower HSU. Age, sex, and education were not associated.

Conclusions
The SF-6D revealed significant discriminatory power for the HOLISM international cohort. Modifiable lifestyle factors including diet, physical activity and supplement use for the international cohort were robustly associated with increased HSU and thus HRQoL. Confirmatory longitudinal HSU evidence could provide further support to our baseline findings using the SF-6D.

Key messages
Health state utilities in this sample of people living with MS were moderate and were significantly lower among those with greater disability, fatigue, and depression, while some lifestyle factors like physical activity and supplement use were associated with higher utility scores.
99Increasing prevalence of primary biliary cholangitis in Victoria, Australia
Authors: French Janine , van der Mei Ingrid , Simpson-Yap Steve , Ng Justin , Angus Peter , Lubel John , Nicholl Amanda , Sood Siddharth , Roberts Stuart , Kemp William , Arachchi Niranjan , Dev Anouk , Thompson Alexander , Gow Paul 
Published: September 2021

Abstract

Background
The prevalence of primary biliary cholangitis (PBC) reported in different countries varies significantly and in some parts of the world appears to be increasing.
The aim of this study was to determine the 2013 prevalence of PBC in Victoria, Australia, and to determine the time trend by comparing it with previous studies undertaken in 1991 and 2002.

Methods
Four case-finding methods were used to identify cases of PBC in Victoria: (1) physicians’ survey; (2) tertiary hospital search; (3) liver transplant database search; and (4) private pathology antimitochondrial antibody search.

Results
The prevalence of PBC in Victoria, Australia, is 189.0 per million using all four methods. The average annual increase in prevalence from 1991 to 2013 was 7.7 per million per year. Using the same case-finding methods as the 1991 Victorian prevalence study (methods 1 and 2), the prevalence of PBC increased from 19.1 per million in 1991 to 49.4 per million in 2002 (P &lt; 0.001) and to 80.7 per million in 2013 (P &lt; 0.001).

Conclusions
The current prevalence of PBC in Victoria is significantly higher than previously reported. The use of private pathology-based case-finding methods is important in identifying the maximum number of PBC cases.

Key messages
PBC prevalence in Victoria increased significantly since previous surveys, to 189 per million persons. Including pathology-based case ascertainment yields improved identification of cases.
1392Decline in current tobacco use and socio-economic inequalities in 22 Sub-Saharan African countries- 2003-2018
Authors: Sreeramareddy Chandrashekhar 
Published: September 2021

Abstract

Background
Tobacco companies have shifted their marketing and production to Sub-Saharan African countries which are in an early stage of tobacco epidemic. We report changes in current tobacco use and socio-economic inequalities between 2003 and 2019.

Methods
We estimated country-level, sex-wise, age-standardized prevalence estimates of current tobacco use in 22 SSA countries using sequential Demographic and Health Survey data. On pooled baseline (2003-11) and most recent survey (2011-19) data, prevalence by education, wealth, and age groups; Slope index of inequality and relative index of inequality were estimated. Change in prevalence in each country and by socio-economic subgroups and change in socio-economic inequalities (pooled data) were calculated.

Results
Tobacco use among men ranging [6·1% (Ghana) to 38·3 (Lesotho)] at baseline and [4·5% (Ghana) to 46·0% (Lesotho)] most recent surveys. Decline in prevalence points ranged from 1·5% (Ghana) to 9·6% (Sierra Leone). For women countries where prevalence was &lt;1% rose from nine to 15. In most countries prevalence of current tobacco use significantly declined. WHO target of 30% decline was achieved in 15 and 10 countries for women and men, respectively. In both sexes, tobacco use rate and decline were higher among less educated and poor while magnitude and direction of inequalities were consistently declined. Absolute inequalities three-fold higher among men, while relative inequalities were nearly twice higher among women.

Conclusions
Tobacco use declined in a third of SSA countries. Persistence of socio-economic inequalities warrants stricter implementation of tobacco control measures to reach the vulnerable groups and continued monitoring of inequalities.

Key messages
Contrary to the projections, tobacco use had significantly declined in most of the countries, and many achieved the WHO target of 30% reduction.
Country-level monitoring by regular surveys is needed to track the equitable progress to international goals.
669Rheumatic Heart Disease outcomes in Australia: a linked data analysis
Authors: Stacey Ingrid , Bond-Smith Daniela , Seth Rebecca , Cannon Jeffrey , Murray Kevin , Ralph Anna , Carapetis Jonathan , Hung Joe , Katzenellenbogen Judith 
Published: September 2021

Abstract

Background
Rheumatic Heart Disease (RHD), a chronic acquired heart-valve disease, is a major contributor to morbidity and mortality among Indigenous Australians. We estimate the probability and determinants of progressing from RHD diagnosis to cardiovascular complications/death in the Australian population, addressing methodological shortcomings in existing evidence.

Methods
This retrospective cohort study used linked RHD register, hospital and death data from five Australian jurisdictions. Cardiovascular complications (heart failure, stroke, endocarditis, atrial fibrillation) and all-cause mortality were measured for people aged &lt;35years diagnosed with first-ever RHD (2010-2018; minimum 8.5year look-back; maximum 8year follow-up). Probability of cardiovascular complications were determined with competing risk of death. Proportional cause-specific hazard regression measured independent predictors of outcomes.

Results
1718 RHD cases aged &lt;35years were identified (85% Indigenous, 11% migrant, 63% women, 40% 5-14years, 16% metropolitan). Within 8years, 22% experienced a cardiovascular complication (50% heart failure) and 3.2% died. Age ≥14years (Hazard Ratio,HR:2.0, 95% Confidence Interval,CI:1.4-3.0) and metropolitan residence (HR:3.2, 95%CI:2.0-5.1) were associated with increased risk of cardiovascular complications in cases (relative to &lt; 14years and non-metropolitan). Record of ARF prior to RHD was protective (HR:0.6, 95%CI:0.4-0.8).

Conclusions
Competing risks methods applied to linked data have provided the most comprehensive multi-jurisdictional estimates of RHD progression to cardiovascular complications/death in Australia. Risk of cardiovascular events was highest in metropolitan areas but clinical history of ARF was associated with reduced risk of progression.

Key messages
Despite access to the world-class Australian healthcare system, one-fifth of initially uncomplicated RHD diagnoses will progress to one of the complications examined within 8years
1391Is outdoor artificial light at night confounding spatial epidemiological studies on greenspace and health?
Authors: Stanhope Jessica , Liddicoat Craig , Weinstein Philip 
Published: September 2021

Abstract

Background
There is a growing body of evidence that exposure to greenspace is good for our health: spending time in greenspace can improve depressive symptoms, obesity, and sleep problems, and reduce the risk of breast and prostate cancer. We also know that exposure to outdoor artificial light at night (O-ALAN) is associated with increased risk of breast and prostate cancer, and can worsen depression, obesity and sleep problems. As both greenspace exposure and O-ALAN have been implicated in the same health outcomes, we aimed to establish if O-ALAN was itself correlated with greenspace, potentially confounding spatial epidemiological studies of greenspace and health outcomes (and vice versa).

Methods
We investigated the correlation between greenspace diversity (Shannon diversity index of National Vegetation Information System’s vegetation classes within 3 km radius buffer zones), and night-time light data (NOAA/NCEI Nighttime Visible Infrared Imaging Radiometer Suite Day/Night Band 2015 Annual Composite product), in Australian major cities.

Results
We identified an inverse correlation between O-ALAN and greenspace diversity.

Conclusions
The finding makes intuitive sense because more developed areas are likely to have fewer trees and more artificial light, which is consistent with our hypothesis that that O-ALAN could be confounding studies of the relationship between greenspace and health. Without considering the potential confounding effects of O-ALAN, public health-driven initiatives such as greenspace conservation and restoration in urban environments may not be optimised for health benefits.

Key messages
Spatial epidemiological studies of greenspace exposure and health should include O-ALAN as a potential confounder (and vice versa).
311Effective prospective study sampling from an existing large-scale national survey using propensity score methods
Authors: Stanley James , Harris Ricci , Cormack Donna , Waa Andrew , Edwards Richard 
Published: September 2021

Abstract

Focus of Presentation
Cohort study recruitment can be complex, often requiring extensive pre-screening to recruit sufficient numbers of exposed and unexposed participants. We discuss a prospective study of the impact of racism on adult health in New Zealand (NZ), with emphasis on propensity-score based sampling and recruitment methods accessing participants from a national survey (NZ Health Survey 2017/18, n = 12,530 eligible adults).
Discussion will cover sampling design, response rate, and confounder balance in the final sample. Key empirical results will be summarised.

Findings
The NZHS provided a sampling frame with complete baseline exposure and covariate data, giving n = 2,099 exposed individuals (reported racial discrimination on NZHS). A propensity-score model (stratified by ethnicity) allowed invitation of unexposed individuals balanced on key sociodemographic confounders.
Recruitment used postal invitations with telephone follow-up: individuals could respond by paper survey, online questionnaire or telephone interview. Response rate was 54%, with comparable rates in exposed/unexposed individuals, with key sociodemographic factors well-balanced by exposure status.

Conclusions/Implications
Racism is an important determinant of health inequity, with limited prospective research in New Zealand. Our approach enabled appropriate recruitment from a sampling frame with baseline exposure status (NZHS), including allowance for exposure variability by ethnicity. Propensity-score matching on baseline covariates allowed for balance on key confounders at invitation, with balance maintained in the final sample.

Key messages
Secondary sampling from large national surveys can provide efficient recruitment for prospective studies. We achieved a highly satisfactory response rate, and propensity-score based sampling substantially balanced confounders between exposed and unexposed groups, enhancing study validity.