bluuebunny/crossref_metadata_2025_split huggingface dataset:
504Patterns of physical activity and sedentary time: Changes and tracking from early childhood
Authors: Downing Katherine , Hinkley Trina , Timperio Anna , Salmon Jo , Carver Alison , Cliff Dylan , Okely Anthony , Hesketh Kylie 
Published: September 2021

Abstract

Background
Little is known about how activity patterns change throughout childhood. This study examined changes and tracking of total volume and bouts of physical activity (PA) and sedentary time (SED) from early to late childhood.

Methods
Volume and bouts of SED and light-, moderate- and vigorous-intensity PA (LPA, MPA and VPA) were assessed by accelerometry at 3-5y (n = 758), 6-8y (n = 473) and 9-11y (n = 478). Mixed models examined changes and generalized estimating equations assessed tracking (β &lt; 0.3=weak, 0.3-0.6=moderate, &gt;0.6=strong), stratified by sex and controlling for baseline age and time between measurements.

Results
Patterns of SED increased and LPA decreased for both sexes. Total volume of MPA decreased for girls, but time in ≥ 1-min bouts increased for both sexes. Total volume of VPA increased for both sexes, with time spent in ≥ 1-min bouts increasing for boys. All volume and bout variables tracked moderately for boys, except SED bouts ≥15-min, LPA bouts ≥5-min and MPA bouts ≥1-min which tracked weakly. For girls, total SED and bouts ≥1-min tracked strongly, while total volume of LPA, MPA and VPA, ≥5- and ≥10-min SED bouts, and ≥1-min LPA and MPA bouts tracked moderately.

Conclusions
Activity patterns changed from early to late childhood, with total volumes and short bouts of PA and SED tracking more strongly than longer bouts. Although MVPA increased slightly, total volume and bouts of SED increased considerably more and, of concern, replaced LPA.

Key messages
Interventions are needed to ensure that young children establish and maintain healthy PA and SED levels from a young age.
1309Breastfeeding and weight retention in women with Gestational Diabetes Mellitus (GDM): LINDA-Brasil Cohort
Authors: Drehmer Michele , Cherubini Kadhija , Vigo Alvaro , Schmidt Maria Inês 
Published: September 2021

Abstract

Background
Breastfeeding seems to be inversely related to postpartum weight retention (PPWR), but this relationship is unclear in women with GDM. We aimed to describe the association between breastfeeding and PPWR at 1 year postpartum in women with GDM.

Methods
Multicentre cohort study of 524 women with GDM enrolled in prenatal clinics of the Brazilian National Health System and followed by telephone up to one year postpartum. Socio-demographics and pre-gestational weight were obtained during recruitment. Breastfeeding and post-partum maternal weight through telephone calls. PPWR was defined as 1-year postpartum weight minus pre-pregnancy weight and categorized as above and below the 80th sample percentile of retention. Breastfeeding was categorized as duration greater or less than 6 months. Adjusted Poisson regression was performed to assess relative risks (RR).

Results
Most women were 30 to 39 years old (50.6%), multiparous (71.0%), 39.5% completed high school, 60.1% were non-white (60.1%). Mean pre-gestational BMI was 30.42 (± 6.7) kg/m² and the mean weight gain during pregnancy was 9.5 (± 7.1) kg. After adjustments for previous variables, breastfeeding for 6 months or more reduced by 35% (RR 0.65; 95% CI 0.47; 0.90, p &lt; 0.01) the incidence of 1-year PPWR up to 80th percentile (≥7Kg) compared to breastfeeding less than 6 months.

Conclusions
Breastfeeding up to 6 months might be encouraged in women with GDM to help preventing higher levels of 1-year PPWR.

Key messages
Breastfeeding up to 6 months was associated with less PPWR at 1 year after delivery in women with GDM.
1311Postpartum weight retention and pregnancy weight gain in women with Gestational Diabetes Mellitus (GDM)
Authors: Drehmer Michele , Silveira Leticia , Bracco Paula , Schmidt Maria Inês 
Published: September 2021

Abstract

Background
Since GDM is important risk factor for type 2 diabetes and maternal obesity can potentiate this outcome, the study sought to describe gestational weight gain and one-year postpartum weight retention (PPWR) in women with GDM.

Methods
Multicentre cohort study of 598 women with GDM enrolled in prenatal clinics of the Brazilian National Health System and followed by telephone up to 1-year postpartum. Socioeconomic and nutritional data were evaluated in recruitment. Gestational weight gain (GWG) and pre-pregnancy BMI were classified according to Institute of Medicine, 2009. PPWR was the difference between weights 1-year postpartum and pre-pregnancy. Chi-square test compared proportions of PPWR, pre-gestational BMI and GWG.

Results
Women had mean age 31.2 ± 6.1 years. Mean pre-pregnancy BMI was 30.3 ± 6.5 kg/m², GWG was 9.6 ± 7.3 kg and PPWR was 0.8 ± 6.8. Pre-pregnancy BMI over 25 kg/m² was found in 78%, excessive GWG in 37.6% and PPWR 1-year in 47.7%. PPWR ≥ 5kg was found in 27.6% and was higher in excessive GWG (p &lt; 0.001). Women with excessive GWG, 55.2% had PPWR ≥ 5kg. For all categories of pre-pregnancy BMI, there was higher proportion of PPWR ≥ 5kg in those who had excessive GWG.

Conclusions
Almost half of women who had GDM presented weight retention in 1-year postpartum. We found more PPWR in who had excessive pregnancy weight gain.

Key messages
PPWR is common in women with GDM and there is higher proportion of PPWR ≥ 5kg in women with excessive GWG in all pre-pregnancy BMI categories.
857Data harmonisation of Australian and New Zealand ambulance service datasets
Authors: Eastwood Kathryn , Johnson Alison , Jones Angela , Cameron Peter , Teede Helena 
Published: September 2021

Abstract

Background
Australia has eight state-based ambulance services and New Zealand (NZ) has two. Significant variation between their datasets compromises cross-border research opportunities and translation of research to improve patient care. Ambulance data harmonisation has occurred in the United States and United Kingdom however, to-date no data harmonisation has occurred in Australia. This study aims to compare ambulance service variables in Australia and NZ to identify opportunities and barriers for harmonisation.

Method
Available 2019 variables were mapped to each other and several international standardized terminology systems to identify variations and similarities in variable names and definitions, and harmonisation opportunities.

Results
Four Australian ambulance services used one electronic patient care record (ePCR) system, three used other ePCR systems, one used paper-based records and both NZ services used one ePCR system. Only the NZ services had mapped their variables to two international standardised terminology systems.
Barriers to harmonisation included the variables collected, the variable definitions and the variable naming convention. The core variables available for mapping varied and numbered from 27-69. Differences included similar variable names having different definitions, variables that should have different definitions having the same, and naming convention for similar/same variables differing between services.

Conclusions
Ambulance service data harmonisation in Australia and NZ is possible and presents significant opportunities for improvement in patient outcomes and performance audit. It would facilitate quality, large-scale, high-impact collaborative national and international research.

Key Message
There is an opportunity for Australian and NZ ambulance services to harmonise their data to conduct large scale international research.
1217The prevalence of post-traumatic stress disorder in Syrian refugees increased after long-distance migration
Authors: Eiset Andreas Halgreen , Aoun Michaelangelo P. , Stougaard Monica , Gottlieb Annemarie Graa , Haddad Ramzi S. , Frydenberg Morten , Naja Wadih J. 
Published: September 2021

Abstract

Background
Refugees are forced migrants but there is a large variation in the distance that refugees cover. Previous studies suggest an inverse association between long-distance migration and self-reported health in the general population but there is a knowledge gap in the health effects of migration in refugee populations. Here, we estimate the association between long-distance migration and post-traumatic stress disorder (PTSD), a severe mental health disorder associated with deteriorating mental and somatic health.

Methods
Included were 712 adult Syrian refugees and asylum seekers newly arrived in Lebanon and Denmark. PTSD was assessed using the Harvard Trauma Questionnaire, confounding was handled by propensity score-weighting with covariates age, sex, socioeconomic status, trauma experience, and WHO-5-score after multiply imputing missing data, and the 95-percentile confidence interval (CI) was computed by bootstrapping.

Results
The prevalence of PTSD was high in both Lebanon (55%) and Denmark (60%). After adjusting for biases the prevalence difference increased to 9 percentage point (95-percentile CI: [-1; 19] percentage point). All sensitivity analysis produced estimates of the same magnitude and direction, except when grossly violating the assumption of multiple imputation which halved the magnitude of the association.

Conclusions
Long-distance migration was associated with an estimated 87 additional cases of PTSD for every 1000 Syrian refugees. This is a first step in examining the effects of migration in refugee health.

Key messages
Long-distance migration was positively associated with prevalence of post-traumatic stress disorder in Syrian refugees.
444Frailty status and all-cause mortality in the community-dwelling individuals: An umbrella review
Authors: Ekram A R M Saifuddin , Ryan Joanne , Britt Carlene , Espinoza Sara , Woods Robyn 
Published: September 2021

Abstract

Background
Frailty is increasingly recognised for its association with adverse health outcomes, including mortality. However, various measures are used to assess frailty, and the strength of association could vary depending on the specific definition used. This umbrella review aims to map which frailty scale can best predict the relationship between frailty and all-cause mortality among community-dwelling older people.

Methods
A protocol was registered at PROSPERO, and it was conducted following the PRISMA statement. MEDLINE, Embase, PubMed, Cochrane Database of Systematic Reviews, Joanna Briggs Institute (JBI) EBP database, and Web of Science database was searched. Methodological quality was assessed using the JBI critical appraisal checklist and online AMSTAR-2 critical appraisal checklist. For eligible studies, essential information was extracted and synthesized qualitatively.

Results
Five systematic reviews were included, with a total of 434,115 participants. Three systematic reviews focused on single frailty scales; one evaluated Fried's physical frailty phenotype and its modifications; another focused on the deficit accumulation frailty index. The third evaluated the FRAIL (Fatigue, Resistance, Ambulation, Illness, and Loss of weight) scale. The two other systematic reviews determined the association between frailty and mortality using different frailty scales. All of the systematic reviews found that frailty was significantly associated with all-cause mortality.

Conclusion
This umbrella review demonstrates that frailty is a significant predictor of all-cause mortality, irrespective of the specific frailty scale.

Key messages
Frailty is associated with an increased risk of all-cause mortality in community-dwelling individuals signifying the importance of assessment in the primary healthcare setting.
1247Low-calorie sweeteners consumption: a population-based study from Campinas, Brazil
Authors: Grilo Mariana Fagundes , Duran Ana Clara 
Published: September 2021

Abstract

Background
The addition of low-calorie sweeteners (LCS) has been increasingly used by industry but their metabolic effects are controversial. Objectives: to estimate the consumption of foods and beverages with LCS among adolescents, adults and the elderly and to verify which food categories most contribute to this consumption.

Methods
Cross-sectional study. We used data from the Campinas Health Survey (ISACamp 2014-15) and the Food Consumption and Nutritional Status Survey (ISACamp-Nutri 2015-16) of 2570 individuals from 10 years old. We estimated the prevalence of LCS consumption and described the food categories that most contributed to this consumption. Using regression analysis, we verified which population groups had the highest consumption of products with LCS.

Results
More than 40% of adolescents, adults and the elderly consumed at least one product with LCS, mainly coming from sweetened beverages, tabletop sweeteners, and yogurt and other dairy beverages. The consumption of LCS was evenly found across adolescents and elderly from all socioeconomic strata, and whether elderly participants presented overweight and/or diabetes. Among adults, greater prevalence of foods and beverages with LCS consumption was found in those with higher education but did not vary by the presence of overweight and/or diabetes.

Conclusions
We found similar consumption of foods and beverages with LCS in most socioeconomic strata, and in participants with and without overweight or diabetes.

Key messages
The results can contribute to the development of public policies on clearer information of LCS addition in food labels.
902Effect modification by homeownership in the relationship between household income and child oral health
Authors: Alfonzo Ludmila Fleitas , Bentley Rebecca , Singh Ankur 
Published: September 2021

Abstract

Background
Poor oral health among children is socially patterned and poorly understood. To optimise interventions aimed at reducing the persistent socioeconomic gap in health, we need to understand its shaping mechanisms. We examined if homeownership modifies the widely recognised association between household income and child oral health.

Methods
Data were analysed on 3,344 children from the Longitudinal Study of Australian Children. Multivariable regression models tested associations between tertiles of household income and dental decay and tooth loss. Effect modification by homeownership was tested on both additive and multiplicative scales. Models were adjusted for demographic variables, area of residence and family characteristics.

Results
For dental decay and tooth loss, children in households in the lower tertiles of income had worse oral health than children in the highest. Additive interaction was weakly supported in our models. The relative effect of income on oral health was greater for homeowners than renters for dental decay (medium household income 0.65 (95%CI: 0.44; 0.98) and low household income 0.82 (95%CI: 0.58; 1.15)) and tooth loss (medium household income 0.25 (95%CI: 0.09; 0.68) and low household income 0.41 (95%CI: 0.17; 0.97)).

Conclusions
Low-income children have poorer oral health outcomes. Although children of homeowners have better oral health than children of renters, income inequality is higher among the homeowner’s group. Current rent assistance programs for low-income families in Australia may minimise income-related inequalities on a relative scale.

Key messages
Our findings shed light on the potential of equalising policies in reducing income-related oral health inequalities.
1421Effects of the Colombian armed conflict on reproductive, maternal and child health
Authors: Garcés-palacio Isabel , Salazar-Barrientos Mary , Bedoya Edison Bedoya , Langer Ana 
Published: September 2021

Abstract

Background
Colombia has been affected by internal armed conflict for 70 years. About 7.3 million people have been internally displaced and nearly 50% of them were women. In conflict-afflicted areas, pregnant women and newborns have higher rates of adverse health outcomes.

Methods
Secondary analysis of public databases. We examined sixteen indicators from the Countdown to 2030 initiative, for which data from Colombia were available and reliable between 1998 and 2016. We also constructed a variable (victimization rate) to measure the intensity of the conflict for each municipality/year and grouped them into quintiles. We compared relative differences and confidence intervals using the Rothman and Greenland method.

Results
Across time, most indicators improved in all municipalities. However, four indicators were significantly different between municipalities with high versus low victimization rates. The maternal mortality ratio was higher in the municipalities with higher victimization rates in the periods 1998-2004, 2005-2011 and 2012-2016. The percentages of caesarean births and women who received four or more antenatal care visits were lower in settings with highest levels of victimization (1998-2000,) while the fertility rate among women 15-19 years old was higher in those municipalities between 2012 and 2016.

Conclusions
In Colombia, several maternal and child health indicators have improved during the years of the conflict; however, municipalities most affected by the armed conflict had poorer reproductive and maternal health outcomes.

Key messages
Maternal and reproductive health were negatively affected by protracted armed conflict in Colombia.
1201Vitamin D and family history of hypertension in relation to hypertension status among college students
Authors: Cuffee Yendelela , Wang Ming , Geyer Nathaniel , Akuley Susanne , Saxena Sangeeta , Jones Lenette , Wilson Robin Taylor 
Published: September 2021

Abstract

Background
Whereas hypertension and vitamin D concentrations have heritable components, these factors have not been investigated concurrently among young adults. The objective of this study is to investigate hypertension risk among young adults with respect to family history of hypertension, adjusting for vitamin D status.

Methods
Resting blood pressure was measured in 398 college students aged 18-35 and classified according to the 2017 American Heart Association criteria. Plasma vitamin D metabolite (25(OH)D3; 24,25(OH)2D3; 1,25(OH)2D3) concentrations were determined using liquid chromatography tandem mass spectrometry (LC-MS/MS). Stepwise logistic regression was used to select covariates.

Results
Nearly 40 percent of young adults were classified with elevated blood pressure or hypertension. Compared with no parental history, the adjusted odds ratio (AOR) for hypertension was elevated among participants with two parents having hypertension (AOR=4.5, 95% CI: 1.70-11.76), adjusting for sex, body mass index, physical activity, and plasma 25(OH)D3. Results for systolic hypertension were similar but more extreme (two parents AOR=7.1, 95% CI: 2.82, 17.66), although dihydroxy metabolites (1,25(OH)2D3 and 24,25(OH)2D3) were significant. Approximately five percent (4.8%) of those with hypertension reported knowledge of their hypertensive status.

Conclusions
The findings suggested a strong influence of dual parental history of hypertension on hypertensive status among young healthy adults. The overall prevalence and the combined lack of self-awareness of hypertensive status among relatively well-educated healthy young adults emphasizes the need for targeted primary and secondary prevention efforts.

Key messages
Hypertension was prevalent in nearly one-third of the sample and underscores the need for targeted prevention for young adults.
1194WebGIS in epidemiology: Lessons from LionVu Usability Assessment within Pennsylvania, United States
Authors: Geyer Nathaniel , Kessler Fritz , Lengerich Eugene 
Published: September 2021

Abstract

Focus of Presentation
LionVu, a web-based mapping tool using Leaflet JavaScript, was recently redesigned to better meet the needs of clinical, educational, and epidemiological audiences within Pennsylvania, United States, containing publicly available health-related and demographic data sets. In addition, the LionVu Usability Assessment, a 50-question online survey, was conducted to assess whether LionVu’s functionality and improved interface met the needs of its intended audiences. The aim of this qualitative data analysis was to assess the themes of the open-ended questions of the LionVu Usability Assessment to improve the tool.

Findings
Invitations to the LionVu Usability Assessment were sent in Spring 2020 (n = 123), with 23 who began (55% female), but only 10 completed the survey. The 23 participants were from academia (n = 10), professional settings (n = 10) or missing (n = 3). Six themes emerged as critical to improve LionVu’s functionality: improving documentation and training materials, enhancing map customizability, including tabular displays below the maps, adjusting the colour schema, saving outputs as files, and displaying maps side-by-side.

Conclusions/Implications
LionVu fills a niche in the health community by giving clinical, educational, and epidemiological audiences the ability to visualize and utilize health data at various levels of aggregations and geographical scales (i.e., state, county, zip code, etc.). Novel applications like LionVu can serve data for future purposes such as mapping and graphing in epidemiology.

Key messages
The usability study of LionVu provided important feedback for its future development. Lessons and best practices on developing comparable WebGIS applications, for clinical, educational, and epidemiological audiences, are addressed.
1515Screened blood pressure and its associated factors among adolescents
Authors: Ghammem Rim , Soua Sarrah , Zammit Nawel , Fredj Siheme Ben , Nasrallah Cyrine Ben , Misbah Rania , Maatoug Jihene , Ghannem Hassen 
Published: September 2021

Abstract

Background
Hypertension (HTN) could have its origin in childhood and remain undetected unless a special screening is done during this period. We conducted this study to determine the screened HTN prevalence in adolescents and its associated factors, in order to increase the awareness on this subject and lead the state to make preventive strategies.

Methods
A cross-sectional study was carried among secondary school students in Sousse, Tunisia, during 2017-2018 school year. Blood pressure and anthropometric indices were measured. A structured questionnaire was used to collect information about socio demographic characteristics, lifestyle, addictive behavior and mental health status.

Results
A total of 1399 adolescents participated in the study. The prevalence of screened HTN was 15.6% (95% CI[13.8% -17.5%]). It was significantly higher in boys (23.1%) than in girls (10.7%; p ≤ 10-3).
After binary logistic regression, positively associated factors to screened HTN in total population were: obesity (aOR=3.69; p ≤ 10-3), and overweight (aOR=1.7; p ≤ 10-3). Female gender (aOR=0.4; p ≤ 10-3), School failure (aOR=0.64; p = 0.014) and depression (aOR=0.67;p=0.017) were negatively associated to screened HTN.

Conclusions
Our study showed an alarming prevalence of high blood pressure among secondary school adolescents in our Low Middle Income Country and that it was mainly associated with weight excess. This emphasizes the emergent need of a comprehensive strategy for the prevention and control of hypertension and NCD risk factors among youth.

Key messages
Hypertension is an alarming emerging problem among youth in LMIC
The emergent need of an effective strategy to prevent NCD risk factors in LMIC

Keywords
Hypertension Prevalence - Adolescent lifestyle- behavior, addictive - mental health