bluuebunny/crossref_metadata_2025_split huggingface dataset:
475Machine learning approach: identifying the impact of heatwaves and air quality on children’s health
Authors: Patel Dimpalben , Jian Le , Xiao JianGuo , Jansz Janis , Yun Grace , Lin Ting , Pereira Gavin , Robertson Andrew 
Published: September 2021

Abstract

Background
Heatwaves, air pollution and their effects on children’s health can vary temporally and spatially. With the emergence of advanced methods such as machine learning, there is an opportunity to improve prediction of children’s health events associated with those exposures.

Methods
Daily records on emergency department attendances (EDA) for children &lt;15 years, heatwaves, landscape fire burns and air pollutants (CO, SO2, NO2, O3, PM10, PM2.5) were collected for Western Australia, 2006-2015. Decision tree, random forest (RF) and geographical RF (GRF) were compared to predict EDA, identify important risk factors and locations at elevated risk. Validation was performed by comparing actual and predicted EDA.

Results
RF was the best model with the lowest root mean squared error (MSE). The best RF validation model had an r-squared (R2) =0.95. The percentage increase in MSE indicated that PM10 and PM2.5 were important predictors of EDA for all children. Number of burns was more important in 5-9 year age group than other groups. GRF models (R2 0.90-0.98) showed that heatwave and PM2.5 were the important predictors in southern part of the study area for all age groups.

Conclusions
The importance of risk factors to predict EDA was varied by age groups and locations. Such differences are important when developing targeted health promotion strategies tailored to age groups and geographical locations.

Key messages
RF predicted EDA better than other models. Evaluation of spatial variation of heatwave and air quality effects on EDA for children by GRF modelling is useful to identify at risk geographical locations.
424Person-centred outcomes among 22,205 cancer survivors and 244,000 people without cancer: a population-based Australian study
Authors: Joshy Grace , Thandrayen Joanne , Koczwara Bogda , Butow Phyllis , Laidsaar-Powell Rebekah , Rankin Nicole , Canfell Karen , Stubbs John , Grogan Paul , Banks Emily 
Published: September 2021

Abstract

Background
With the majority of people with cancer surviving long-term, holistic consideration of health and wellbeing outcomes is critical to optimise survivorship. We quantified short- and long-term physical and mental health-related outcomes in people with and without cancer, including according to cancer type and clinical characteristics.

Methods
45 and Up Study (n = 267,153) baseline survey data (2006-2009) were linked to cancer registrations (by the Centre for Health Record Linkage) and cancer diagnoses up to enrolment identified. Modified Poisson regression estimated age-and-sex-adjusted prevalence ratios (PRs) for adverse person-centred outcomes - severe physical functioning limitations, moderate/high psychological distress and fair/poor quality of life - in participants with versus without cancer.

Results
Cancer survivors (n = 22,205) had significantly higher prevalence of physical functioning limitations compared to participants without cancer (21% versus 13%) PR = 1.28(95%CI=1.25-1.32), overall and in all population subgroups examined. Corresponding estimates were 22% versus 24% (1.05(1.02-1.08)) for psychological distress and 15% versus 10% (1.28(1.24-1.32) for fair/poor quality of life. Outcomes varied by cancer type, being worse for multiple myeloma, lung cancer and non-Hodgkin’s lymphoma; worse outcomes were also associated with recent diagnosis, recent treatment and advanced stage. Physical functioning limitations in cancer survivors were major contributors to adverse distress and quality of life outcomes.

Conclusions
Cancer survivors experience adverse physical and mental health outcomes; substantial parts of elevated distress and poor quality of life are likely attributable to physical disability.

Key messages
In addition to routine screening for psychological distress, management of physical disability and other symptoms are important to optimise cancer survivorship.
892Quantification of mortality incorporating multiple causes of death: Application of weighting strategies to Australian data
Authors: Joshy Grace , Bishop Karen , Balogun Saliu , Moreno-Betancur Margarita , Eynstone-Hinkins James , Moran Lauren , Korda Rosemary , Rao Chalapati , Banks Emily 
Published: September 2021

Abstract

Background
Mortality statistics are typically based on a single underlying cause of death (UCoD). Although UCoD provides a useful construct, the relevance of assuming that a single disease caused the death is diminishing, especially with increased life expectancy and high proportions of deaths in older ages from chronic/degenerative diseases. Focussing on common underlying causes of death in Australia, we quantified mortality incorporating weighting strategies for multiple causes of death (MCoD).

Methods
All deaths registered in Australia from 2015-2017 (478,396 deaths) and coded using International Classification of Diseases Version 10 were classified using an extended cause list (n = 136 causes) based on a World Health Organization short list. Age-standardised rates (ASR) were estimated using three weighting methods: (1) traditional approach using UCoD alone; (2) UCoD and associated causes of death (ACoDs) equally weighted and (3) UCoD weighted 0.5 arbitrarily and remaining 0.5 apportioned to the remaining ACoDs.

Results
Common UCoD were ischaemic heart diseases, cerebrovascular diseases, dementia; 57671, 31515 and 27377 deaths respectively. There were substantial changes in ASR depending on the weighting method used. Variation in mortality patterns estimated using the three weighting methods and challenges to further refinement of the weighting strategy will be discussed.

Conclusions
Mortality indicators incorporating MCoD enhance traditional measures of mortality and provide a means to reassess the role of diseases in causing death. Further disease specific methods are required to refine current weighting strategies.

Key messages
Weighting strategies for are useful for quantifying mortality incorporating MCoD, but methodological challenges exist.
659‘Ikigai’, subjective well-being and participation in community support activities among the elderly in Japan
Authors: Kamei Midori , Motohashi Chiemi , Inoue Naoko , Nishina Motoko , Ohta Akiko , Miyazaki Takashi , Takahashi Mihoko , Uemura Makiko 
Published: September 2021

Abstract

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Background
Text: ‘Ikigai’, subjective well-being which is the Japanese concept to a good life plays important role for a long and active aging. We examined the cross-sectional association between ‘Ikigai’ 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, ‘Ikigai’, perceived health, and intention to participate in community support activities for the elderly, the children care, and the disabled.

Results
Text: A total of 1,089 (47.7%) persons showed positive intention to participate in community support activities for the elderly. Respondents who had ‘Ikigai’ were 1,796 (78.7%). Respondents who had ‘Ikigai’ were more likely to participate in community support activities for the elderly than those who did not. The same trends were shown in community support activities for the children care or the disabled.

Conclusions
Text: Elderly people who had ‘Ikigai’ were more likely to participate in community support activities. ‘Ikigai’ may have an important role for making mutual ties and good life for active aging in the community.

Key messages
Text: ‘Ikigai’ may have an important role for active aging in the community.
1312Population-attributable fraction estimates for factors of different types of anaemia among women: multilevel multinomial analysis
Authors: KIBRET Kelemu Tilahun , Chojenta Catherine , Loxton Deborah , D'Arcy Ellie 
Published: September 2021

Abstract

Background
Anaemia is one indicator of poor health in women and responsible for substantial mortality. Assessing the relative impact of predictors for anaemia among women could help to prioritize targeted preventions strategies. This study aimed to quantify the attributable burden of modifiable factors for different severity levels of anaemia among Ethiopian women.

Methods
Adjusted odds ratio and exposure prevalence for selected factors were used to calculate population attributable fractions using the 2016 Ethiopian Demographic and Health Surveys data. Adjusted odds ratios (AOR) with 95% confidence intervals (CIs) were computed using multilevel multinomial regression models.

Results
In Ethiopia, an estimated 14.6% (95% confidence interval, CI: 3.4, 24.5) of mild anaemia was attributable to no formal education, 11.2% (95%CI: 1.2, 19.9) to high gravidity (≥ 4) and 5.2% (95%CI: 0, 10.7) to currently breastfeeding. Similarly, proportion of moderate-severe anaemia attributable to rural residence was 38.1% (95%CI: 15.9, 54.8), poorest wealth quantile was 12.6% (95%CI: 2.9, 24.6), previous five years birth was 10.5% (95%CI: 2.9, 18.2), and unimproved latrine was 17% (95% CI: 0, 32.5).

Conclusions
The result suggests that low education, low wealth status, high parity, rural residency, pregnancy and breastfeeding contribute substantially to the occurrence of anaemia among women.

Key messages
Mild anaemia could be reduced by setting intervention strategies targeting women with low education, multigravida women, and breastfeeding women, while preventing moderate-to-severe anaemia may require increasing income, and improving living environments like hygienic latrines.
562The “quiet revolution” and mental health? Associations between household-employment configurations and mental-health across 17 years
Authors: King Tania , Taouk Yamna , LaMontagne Tony , Maheen Doctor Humaira , Kavanagh Anne 
Published: September 2021

Abstract

Background
Despite evidence that employed women report more time pressure and work-life penalties than employed men and other women, scant attention has been paid to the possible health effects of female labour-force participation.

Methods
This analysis examined associations between household labour-force arrangements and the mental health of men and women using 17 waves of data from the Household Income and Labour Dynamics Survey. Mental health was measured using the Mental Health Inventory (MHI-5). A five-category measure of household employment configuration was derived: dual full-time employed, male-breadwinner, female-breadwinner, shared part-time employment (both part-time) and male full-time/female part-time (1.5-earner). Using fixed effects regression methods, we examined the within-person effects of household employment configuration on mental health, controlling for time-varying confounders.

Results
For men, being in the female-breadwinner configuration was associated with poorer mental health compared to being in the 1.5-earner configuration (b-1.98, 95%CI -3.36, -0.61). The mental health of women was poorer when in the male-breadwinner configuration, compared to when in the 1.5-earner arrangement (b-0.89, 95%CI -1.56, -0.22).

Conclusions
The mental health of both men and women is poorer when not in the labour-force, either as a man in the female-breadwinner arrangement, or as a woman in the male-breadwinner arrangement.

Key messages
These results suggest that the mental health of women and men benefits from labour-force participation. The results are noteworthy for women, because they pertain to a sizeable proportion of the population who are not in paid employment, and highlight the need for policy reform to support women’s labour-force participation.
1424Knowledge, Attitudes, and Practices towards COVID-19: An Epidemiological Survey in Mumbai, India
Authors: Kotian Sneha Pratap , Waingankar Prasad , Tawde Ashlesha 
Published: September 2021

Abstract

Background
The COVID-19 pandemic has become a serious public health concern around the world, with countries taking significant preventive and control measures to halt the spread of this deadly virus. The knowledge, attitude & practices (KAP) of the general population play a major role in the containment measures adopted by the country. The current study was conducted to assess the KAP of the population of Mumbai towards COVID-19 pandemic.

Methods
The study was a web-based, cross sectional survey. A Snowball sampling technique was used. The digital forms were made available in local languages. A 25-item survey instrument was developed according to the guidelines issued by the Government to test the KAP of the population about COVID-19. Cronbach’s alpha was used to measure the internal consistency of the questionnaire. Chi-square test or Fischer exact test was used to compare categorical data and multiple linear regression was used to identify factors influencing KAP.

Results
A total of 1360 responses were included in the study. The overall knowledge, attitude and practice score was 83.7%, 77.33% and 63.8% respectively. About 14.85% did not know about the asymptomatic spread of COVID-19.

Conclusion
The assessment of COVID-19 related KAP among the public could be instrumental in providing better insights to the policy makers to deliver tailored health intervention programmes.

Key messages
The findings of this study can serve as a guide to future efforts aimed at public readiness to adhere to control measures to address such emergency crises.
238Social gradient of self-rated health in elderly – the moderating/mediating role of sense of community
Authors: Lai Eric TC , Yu Ruby , Woo Jean 
Published: September 2021

Abstract

Background
Social gradients of self-rated health (SRH) of elderly are evident in various settings. However, it is not clear whether improving elderly’s sense of community (SoC) could mitigate the social gradient.

Methods
Elderly aged 60+ in 5 residential districts of Hong Kong were sampled using multi-stage sampling (n = 1793). SoC was measured using the validated 8-item Brief Sense of Community Scale, with each item on a 5-point Likert scale, forming a score from 8 to 40. SRH was considered as a continuous score from 1 (poor) to 5 (excellent). Socioeconomic status (SES) was operationalized as monthly income, highest education attainment and self-rated disposable income (defined as whether the elderly feels he/she has sufficient income). Causal mediation analysis was used to assess whether SoC mediates/moderates the association of SES and self-rated health.

Results
A social gradient of SRH by all measures of SES was observed [b per SD income increase=0.11; 95% confidence interval (95%CI) 0.07 to 0.16; b comparing lowest to highest education=-0.63; 95%CI -0.84 to -0.43; b comparing very sufficient to very insufficient disposable income=-0.76; 95%CI -0.97 to -0.56]. Causal mediation analysis showed that SoC interacts with the association of education and SRH, with higher the SoC stronger the education gradient. SoC mediates the relationship between disposable income and SRH [pure indirect effect=-0.12 (95%CI -0.20 to -0.03).

Conclusions
SoC interacts/mediates the associations of education/disposable income and SRH by accentuating them.

Key messages
Our findings suggested that improving SoC could not lead to mitigating of social gradient of SRH in the elderly population in Hong Kong.
98Framework for the Treatment And Reporting of Missing data in Observational Studies: The TARMOS framework
Authors: Lee Katherine , Tilling Kate , Cornish Rosie , Carpenter James 
Published: September 2021

Abstract

Focus of presentation
Missing data are ubiquitous in medical research. Although there is increasing guidance on how to handle missing data, practice is changing slowly and misapprehensions abound, particularly in observational research. We present a practical framework for handling and reporting the analysis of incomplete data in observational studies, which we illustrate using a case study from the Avon Longitudinal Study of Parents and Children.

Findings
The framework consists of three steps: 1) Develop an analysis plan specifying the analysis model and how missing data are going to be addressed. Important considerations are whether a complete records analysis is likely to be valid, whether multiple imputation or an alternative approach is likely to offer benefits, and whether a sensitivity analysis regarding the missingness mechanism is required. 2) Explore the data, checking the methods outlined in the analysis plan are appropriate, and conduct the pre-planned analysis. 3) Report the results, including a description of the missing data, details on how missing data were addressed, and the results from all analyses, interpreted in light of the missing data and clinical relevance.

Conclusions/Implications
This framework encourages researchers to think carefully about their missing data and be transparent about the potential effect on the study results. This will increase confidence in the reliability and reproducibility of results from published papers.

Key messages
Researchers need to develop a plan for missing data prior to conducting their analysis, and be transparent about how they handled the missing data and its potential effect when reporting their results.
1275Lifetime cancer risks from occupational radiation exposure among workers at interventional radiology departments
Authors: Lee Won Jin , Bang Ye Jin , Kim Young Min , Cho Sung Bum 
Published: September 2021

Abstract

Background
Interventional medical radiation workers represent an under-studied population worldwide, although they receive relatively high occupational radiation doses. This study aimed to estimate the lifetime cancer risk from occupational radiation exposure among workers at interventional radiology departments.

Methods
A field survey of interventional medical workers in nationwide branches of the Korean Society of Interventional Radiology was conducted in 2017. Organ-specific radiation doses were estimated using national dose registry data and conversion coefficients provided by the International Commission on Radiological Protection. Lifetime attributable risk (LAR) and lifetime fractional risk (LFR) were calculated based on realistic exposure scenarios using a radiation risk assessment tool.

Results
LARs from occupational radiation exposure until the age of retirement for all cancers combined were 338 (90.3-796.1), 121 (33.5-288.7), and 156 (41.1-390.6) per 100,000 individuals for male radiologists, male radiologic technologists, and female nurses, respectively. LFR for all cancers combined ranged from 0.22% (0.06-0.53) to 0.63% (0.17-1.47). Regarding the organ site, the highest LAR and LFR among all groups were observed for thyroid cancer.

Conclusions
This study provides timely evidence of potential cancer burden from the current levels of occupational radiation exposure among workers at interventional radiology departments. The risks varied by occupational groups, and workers, particularly interventional radiologists, need to be carefully monitored for radiation.

Key messages
We projected lifetime cancer risks from occupational radiation exposure among workers at interventional radiology departments in South Korea. Particularly, interventional radiologists, should be prioritized for careful protection from the potential health risks of occupational radiation exposure.
1366Environmental noise exposure and mental health: an analysis of a longitudinal survey of Australian households
Authors: Li Ang , Mansour Adelle , Martino Erika , Bentley Rebecca 
Published: September 2021

Abstract

Background
Persistent exposure to environmental noise in people’s homes has been associated with cardiovascular disease and poor mental health. Many studies conducted on noise and health are based on observational studies and the extent to which findings reflect residual confounding are not known.

Methods
Using the Household, Income and Labour Dynamics survey in Australia, we examine the impact of environmental noise (traffic, airplanes, train, industry) on self-reported mental health measured by the Short Form 36 Health Survey. Fixed-effects longitudinal regression analyses are used to account for differences between people over time, reducing confounding from time-invariant factors and reporting bias. Time-varying factors were adjusted including age, education, equivalised income, employment, household structure, chronic condition, government payment status and tenure type.

Results
Results show a significant decrease in average mental health as the level of noise increased. Exposure to loud traffic noise ‘fairly commonly’ or ‘very commonly’ negatively impacted mental health (-1.18; 95%CI -1.56, -0.81 and -1.33; 95%CI -1.77, -0.89) and exposure to noise from airplanes, trains or industry ‘fairly commonly’ or ‘very commonly’ negatively impacted mental health (-1.57; 95%CI -1.88, -1.27 and -1.48; 95%CI -1.89, -1.08).

Conclusions
This provides robust evidence of short-run mental health effects of noise exposure within people’s homes. More research could be done to explore this over a longer-time frame.

Key messages
With increasing numbers of people living in urban areas, reducing environmental noise near people’s homes or improving the capacity of homes to reduce external sources of noise (e.g. double glazing) may have public health benefit.
548Cancer treatment and survival disparity in South Australia women with invasive breast cancer during 2000-2014
Authors: Li Ming , Roder David 
Published: September 2021

Abstract

Background
Survival improvement from breast cancer has been attributed mostly to treatment advances and earlier cancer detection. This study was to investigate cancer treatment and the association with survival.

Methods
A total of 13494 female patients with invasive breast cancer recorded on the South Australia Cancer Registry in 2000-2014 were included. Cancer treatments within 12 month following diagnosis were identified from linked cancer registry and other medical registries. Study factors included demo sociographic, tumour profile and comorbidity. Adjusted odds ratios and sub hazard ratios were reported on treatment and survival disparity respectively.

Results
98% patients were treated with one or more treatment types. 56% had conserving surgery. Systemic treatment was received by 72%. Older patients with advanced cancer were less likely to have any treatment. Women in the most socioeconomically advantaged area were less likely to have combined mastectomy and conservative surgery (aOR 0.73, 95% CI 0.54-0.98), but more likely to have systemic treatment (aOR 1.44, 95% CI 1.26-1.64). Other factors such as country of birth, residential socioeconomic status, cancer differentiation, and diagnosis period differed in their associations with treatment type. Having conserving surgery predicted the lowest breast cancer death (adjusted SHR 0.31, 95% CI 0.26-0.36) compared to no surgery.

Conclusions
Breast cancer patients underwent varied treatment types with different impact on breast cancer mortality.

Key messages
Patients undergoing conserving surgery were at the lowest risk of the cancer death.