bluuebunny/crossref_metadata_2025_split huggingface dataset:
980Quantifying inadvertent data-duplication- findings from validation of antenatal-registration and HIV-testing data-sets from an Indian state
Authors: Godbole Sheela , Chidrawar Shweta , Sane Suvarna , Bansal Yashika , Hegde Asha , Bembalkar Shilpa , Kamble Suchit , Mamulwar Megha , Acharya Shrikala , Bawiskar Vijay , Ramakrishnan Laxmi , Raj Yujwal , Gangakhedkar Raman , Kumar Ashok , Reddy D C S , Pandey Arvind , Saidel Tobi , Rani Naina , Seguy Nicole , Sachdeva K S 
Published: September 2021

Abstract

Background
India plans elimination of HIV-Mother-to-Child-Transmission in 2020. Targets include &gt;95% coverage of Antenatal-care (ANC) and HIV-testing. In 2015-16, while 43% of the estimated Indian pregnant-women (PW) received HIV-tests, one state reported &gt;95% testing. Indian public-health-care is a three-tiered system from primary-level sub-centres (population-5000) to tertiary-level hospitals. ANC involves multiple-visits per pregnancy at different care-levels and data are aggregated in the Health-Management-Information-System (HMIS) at all levels. We validated (public and private-sector data from this state, for duplication in ANC registration and HIV-testing using mixed methods.

Methods
In the absence of guidelines for assessing aggregate-data duplication, we used mixed-methods, including surveys among 9845 PW and providers from 240 facilities in 10/36 representative districts; in-depth-interviews; case-studies and analysis of HMIS and HIV-program data (April 2015-Mar 2017). Interviews and case-studies highlighted inadvertent duplicate data-capture. Surveys quantified levels of duplication and adjustment factors (public and private-sector) were developed.

Results
Twenty-four% PW, visited multiple facilities for ANC, while 81% providers reported all the PW coming to their facilities as new ANC registrations (irrespective of lower-tier registration); identifying a minimum duplication of 19% (24%*81%) in ANC coverage. Twenty-nine% and 28% PW from public and private-facilities reported &gt;1 HIV-test; while 75% and 36% reported visiting another public-facility where HIV test was likely to be reported again. Minimum duplication of 22% and 10% in HIV testing was noted in public and private-sectors respectively.

Conclusions
We report methods to quantify repeat HIV-testing and duplicate-reporting, due to inherent processes in ANC in public-healthcare in India. Modification of data-capture was recommended and adopted across India.

Key messages
Assessing duplication in aggregate health data is key to developing robust datasets for disease elimination
427How does childhood maltreatment influence cardiovascular disease? A sequential causal mediation analysis
Authors: Soares Ana Goncalves , Howe Laura D , Hammerton Gemma , Heron Jon , Rich-Edwards Janet , Magnus Maria C , Halligan Sarah L , Fraser Abigail 
Published: September 2021

Abstract

Background
Childhood maltreatment (CM) has been associated with cardiovascular disease (CVD), but the mechanisms of this relationship are not fully understood. We explored the relative contribution of anxiety/depression, smoking, body mass index (BMI) and C-reactive protein (CRP) to the association between CM and CVD in the United Kingdom (UK) and whether this differed by sex and type of maltreatment.

Methods
We used data from 40,596 men and 59,511 women from UK Biobank. To estimate the indirect effects of CM (physical, sexual and emotional abuse, and emotional and physical neglect) on incident CVD, we applied a sequential mediation approach using g-computation.

Results
Together anxiety/depression, smoking, BMI and CRP mediated 26%-90% of the association between CM and CVD, and the contribution of these mediators differed by type of maltreatment and sex. For sexual abuse, emotional abuse and emotional neglect, anxiety/depression was the most important mediator (accounting for 16%-43% of the total effect), especially in women. In men, BMI contributed the most in associations of physical abuse and physical neglect with CVD; in women anxiety/depression and BMI had similar contributions.

Conclusions
These findings add to the understanding of how CM affects CVD and highlight the potential to reduce the burden of CVD in people exposed to CM through targeting modifiable mediating factors.

Key messages
Anxiety/depression, smoking, BMI and inflammation mediated part of the association between CM and CVD, and the contribution of these mediators differed by type of maltreatment and sex.
1173The impact of adverse and positive experiences on inflammatory outcomes in Australian and UK children
Authors: Guo Shuaijun , Gondek Dawid , O’Connor Meredith , Cahill Stephanie , Downes Marnie , Moreno-Betancur Margarita , Burgner David , Slopen Natalie , Goldfeld Sharon , Wake Melissa , Juonala Markus , Kerr Jessica , Lycett Kate , Wang Yichao , Lacey Rebecca , Priest Naomi 
Published: September 2021

Abstract

Background
Inflammation is one of key mechanisms linking childhood experiences to later chronic disease risk. Childhood adversity is associated with inflammation, but little is known about positive experiences. We examine how adverse and positive experiences are associated with inflammatory markers in late childhood, and whether they have an interaction effect.

Methods
Data sources: Longitudinal Study of Australian Children (LSAC; N = 1237) and Avon Longitudinal Study of Parents and Children (ALSPAC; N = 3488). Exposures: Adverse and positive experiences assessed from 0 to 11 (LSAC) and 0-14 years (ALSPAC). Adversity indicators included parent legal problems, family violence, mental illness, substance abuse, harsh parenting, parental divorce, neighbourhood violence, family member death, and bullying victimization. Positive experiences included positive parenting practice, trusting and supportive relationships, supportive neighbourhood and home learning environments, social engagement and enjoyment. Outcomes: Inﬂammation quantiﬁed by high-sensitivity C-reactive protein (hsCRP) and glycoprotein acetyls (GlycA). Analyses: Linear regression was used to estimate relative change in inﬂammatory markers, adjusted for sociodemographics. Outcomes were log-transformed.

Results
Exposure to adversity was associated with higher levels of inﬂammation (e.g., CRP: β = 8.8%, 95% CI= -16.5% to 34.2% in LSAC), whereas exposure to positive experiences was associated with lower levels (e.g., CRP: β=-18.9%, 95% CI= -45.8% to 7.9% in LSAC), after adjusting for sociodemographics. There was no interaction effect of adverse and positive experiences on inflammation.

Conclusions
Adverse and positive experiences have independent and small effects on children’s inflammation across two cohorts.

Key messages
Positive experiences are critical to inform interventions to improve inflammatory outcomes for children who face adversity.
158Prediction of diabetes and hypertension by opportunistic screening: A facility based study from rural Jodhpur
Authors: Gupta Manoj Kumar , Raghav Pankaja , Bhardwaj Pankaj , Rustagi Neeti , KH Naveen , Goel Akhil D , Thirunavukkarasu Prasanna , Sharma Prem Prakash 
Published: September 2021

Abstract

Background
Nearly half of population with Diabetes and Hypertension is estimated to be undetected in India. The objectives of this study were to conduct opportunistic screening for Diabetes and Hypertension coming to OPD of health centres under Department of Community Medicine and Family Medicine, AIIMS Jodhpur, India and to develop the models for prediction of Diabetes and Hypertension.

Methods
Time bound study was conducted at three rural health centres between 2018-19. A total of 942 patients aged ≥30 years were screened. Data was recorded using Epicollect5. Risk assessment was done by using Indian Diabetes risk score (IDRS), Community based assessment checklist (CBAC), Waist Hip Ratio, & BMI. Random and fasting capillary blood sugar and BP was measured.

Results
The mean age of the participants was 52.4 ± 13.5 years. As much as 446 (47.4%) had IDRS score of ≥ 60 and 276 (29.3%) had CBAC score of ≥ 4. RBS level of ≥ 140mg/dl was found among 223 participants, of these, 42.5% were diagnosed to be diabetic on FBS. One-fourth (25.6%) were estimated to be hypertensive. Physical activity and hypertension were best predicting the diabetes (r2= 90.8), while hypertension was best predicted by age and BMI (r2= 74.3).

Conclusions
Prevalence of diabetes and hypertension was in accordance with the reported prevalence in the country. As compared to existing models, less number of prediction variables were identified for NCDs.

Key messages
The study highlights the need for implementation of hospital based opportunistic screening and point out the necessity to revise the existing prediction models for NCDs.
189Mobilizing for change through UM PEACE (Prevent Elder Abuse and negleCt initiativE) Program
Authors: Hairi Noran Naqiah 
Published: September 2021

Abstract

Focus of Presentation
Elder abuse and neglect (EAN) includes psychological, physical, sexual abuse, neglect, and financial exploitation. Malaysia – projected to become an aged nation by 2030 – is not spared. PEACE focuses on protecting elder rights, empowering the community to be actively engaged in elderly issues, and refining the Malaysian law to address existing gaps.

Findings
Our cohort study revealed that the overall lifetime prevalence of EAN (abuse episodes ever experienced from the age 60) was 8.1% with 4.8%, 3.4%, 1.2%, 0.3% and 1.1% for financial abuse, psychological abuse, physical abuse, sexual abuse and neglect respectively. Perpetrators tend to be family members (adult children) and abuse usually occurs at home. Premature mortality are shown higher among victims. From the legal perspective, the only existing act addressing family violence is the Domestic Violence Act (DVA 1994) and Penal Code. The DVA is neither adequate nor specific to EAN and dynamics of elder abuse. Our findings were presented to the relevant stakeholders including the Deputy Prime Minister of Malaysia. Using four main approaches - making findings understandable to policymakers, increasing opportunities for interaction, addressing barriers and ensuring research is relevant allows better communication between researchers and policy makers and ensuring evidence are translated to policy. PEACE are working on drafting the new Elder Act which will be ready by 2021.

Conclusions/Implications
The PEACE program is an example of how a complex health problem should be addressed. Better communication strategies and multiple interactions between policy makers and PEACE researchers is key to our impactful research.

Key messages
Dissemination approaches should be timely and consistent with culture to translate research evidence to policy.
Protecting the well-being and dignity of our elders is not only a question of conscience or morality, but also a matter of upholding human rights and justice.
697Change of smoking habits by introducing and spreading heated tobacco products in Japan
Authors: Harada Sei , Sata Mizuki , Matsumoto Minako , Takeuchi Ayano , Iida Miho , Kato Suzuka , Hirata Aya , Kuwabara Kazuyo , Sugiyama Daisuke , Okamura Tomonori , Takebayashi Toru 
Published: September 2021

Abstract

Background
Heated tobacco product (HTP) users are rapidly increasing in Japan since 2014. Controlling HTPs is now one of the most urgent issues. We aimed to clarify the change of smoking habits by introducing and spreading HTPs.

Methods
We conducted the survey of HTP use in the participants of the Tsuruoka Metabolomics Cohort Study, a prospective cohort including 11,002 participants aged 40-74 in Japan. All data were obtained in the follow-up (2018-2019) and baseline (2012-2013) survey. Smoking habits were categorized to five groups according to follow-up survey; never smokers (NS), past smokers (PS), cigarette only smokers (CS), HTP only smokers (HS) and dual smokers (DS). Linear regression analysis was performed to examine the association between smoking habits and change of number of smoking tobacco products during follow-up.

Results
Prevalence of HTP user was 12.4% in 40-59 years of age and 1.8% in 60-79 for male, and 1.7% in 40-59 and 0% in 60-79 for female. Dual smokers accounted for 34.9% of all HTP users. Change of smoking number during follow-up (5.7±0.8 years) was +3.11 (95%CI: 1.17, 5.07) in DS and -1.09 (-2.70, 0.53) in HS compared with CS, after adjusted for age, sex and smoking number at baseline.

Conclusions
HTPs smoking including dual smoking was getting popular in Japan. Shift to HTPs was unlikely to affect the number of smoking tobacco, but dual smokers tended to smoke more than at baseline.

Key messages
Dual smokers of cigarettes and HTPs tended to smoke more than before introducing and spreading HTPs.
1245Culturally-appropriate research supporting a co-designed childhood obesity prevention program tailored for Māori & Pacific Islanders
Authors: Hardt Jessica , Matautia Brent , Tanuvasa Elkan , Peu Tevita , Kira Kirstine , Santos Daphne , Brignano Sebastien 
Published: September 2021

Abstract

Background
Children of Māori & Pacific Islander descent living in Australia experience higher rates of obesity, increasing their risk of developing life diminishing chronic diseases. However, community-based, childhood obesity prevention programs, tailored to the Māori & Pacific Islander population are lacking, further escalating the rates of health inequity.

Methods
Program co-design involved a three-phase, iterative, participatory and experienced-based process, guided by the Te Ara Tika: Guidelines for Māori Research Ethics, promoting respect and equity. Following traditional oratory customs of Māori & Pacific Islander cultures, “talanoa” facilitated the collaborative program design with consumers, cultural advisors and health professionals.

Results
Co-design developed an 8-week community-based childhood overweight/obesity prevention program, providing culturally-tailored education across nutrition, physical activity and parenting practices. Maximum engagement demonstrated life-changing improvements across the life course; 72% of children and 67% of parents reduced their sugar sweetened beverage consumption and 60% of children and 47% of adults increased their vegetable consumption. Resultingly, BMI z-score decreased among 59% of children and BMI decreased among 47% of parents.

Conclusions
Endorsing a bottom-up approach, via a co-design methodology, significantly improves culturally-tailored health care delivery. An evidence-based framework developed holds significant potential to be scaled to additional cultural groups. A consumer-led approach is pivotal to sustaining engagement and improving health outcomes, addressing health inequity among Australia’s priority populations.

Key messages
Co-design empowered consumers to formulate program objectives, session plans, resources and evaluation tools. Co-designed quality improvement practices ensure relevance of the program to sustainably address community needs, tackling the complexities of obesity over generations.
1258Development of a valid evaluation tool assessing health behaviours among Māori & Pasifika young people
Authors: Hardt Jessica , Cooper Ellen , MacMillan Freya , Brignano Sebastien , Kira Kirstine , Santos Daphne , Thompson Rhonda , Simmons Distinguished David , McBride Kate 
Published: September 2021

Abstract

Background
The Māori & Pasifika population experience high rates of health inequity, with a greater prevalence of obesity and the associated, life diminishing comorbidities. This is in part attributable to higher socioeconomic disadvantage, low health literacy and a lack of culturally tailored health services. Currently no validated tool exists to assess health behaviour change among Māori & Pasifika populations or success of tailored health interventions to tackle chronic disease.

Methods
The project incorporates a comprehensive validation and pilot testing process, including 1) cognitive interviewing and 2) test-retest reproducibility. Participants will include a representative sample of Māori & Pasifika young people and their parents/guardians. All research methodology is guided by cultural experts, specific to the Māori & Pasifika population.

Results
Qualitative data collected via cognitive interviewing will provide feedback regarding the readability, comprehension and content validity of the questionnaire items. Thematic analysis will inform improvements, optimising participant understandability. Cronbach’s alpha will be used to assess internal consistency and Pearson’s r will determine questionnaire test-retest reproducibility.

Conclusions
A validated questionnaire articulating with cultural values will provide meaningful data to researchers, health practitioners and government bodies regarding the lifestyle decisions of Māori & Pasifika peoples. Enhanced monitoring will determine the success of health initiatives to improve health outcomes of a priority population, across Australia and internationally.

Key messages
Lifestyle programs aiming to improve health outcomes are increasingly adapted to incorporate and acknowledge cultural values. Reliable measurement tools, including questionnaires, are fundamental to advancing future health research and tackling health inequity among priority populations.
1302Potential exposure-response relationships between vitamin D and cognitive performance in middle to older-aged adults
Authors: Harse Janis , Zhu Kun , Bucks Romola , Hunter Michael , Lim Ee Mun , Cooke Brian , Walsh John , Murray Kevin 
Published: September 2021

Abstract

Background
Low vitamin D status is consistently associated with poorer global cognition in older adults, particularly women, but findings in relation to higher status are unclear. A better understanding of the relationship across the range is required.

Methods
We investigated patterns of association between serum levels of 25-hydroxyvitamin D (25OHD), the standard measure of vitamin D status, and cognitive performance in 4872 middle to older-aged adults from the Busselton Healthy Ageing Study. Global cognition and performance in domains of attention, memory, and executive function were modelled using linear regression and restricted cubic splines, while controlling for demographic, lifestyle, and health factors.

Results
Mean (SD) serum 25OHD levels were 78 (24) nM/L for women and 87 (25) nM/L for men. Positive, linear patterns for global cognition in women (p = 0.023) and attention accuracy in men (p = 0.022) suggested cognitive performance improved throughout the range. A non-linear pattern for attention accuracy in women suggested performance improved up to 25OHD levels of approximately 80 nM/L and then plateaued (p = 0.035). In men, negative patterns for semantic verbal fluency (linear, p = 0.025) and global cognition (non-linear, p = 0.015) suggested performance declined as 25OHD levels increased.

Conclusions
Effects were small and patterns of association were inconsistent for men and women and across domains. However, the positive patterns identified for women, particularly in relation to attention accuracy, have biological plausibility as early, exposure-response relationships.
751Investigation of the obesity paradox in kidney cancer: mystifying association or myth?
Authors: Heath Alicia , Clasen Joanna , Riboli Elio , Scelo Ghislaine , Muller David 
Published: September 2021

Abstract

Background
An “obesity paradox” has been reported in kidney cancer, whereby obesity is a risk factor, yet appears to be associated with better survival.
To evaluate this paradox, we investigated the association between pre-diagnostic adiposity and renal cell carcinoma (RCC) incidence and mortality.

Methods
Using data from 363,521 men and women in the European Prospective Investigation into Cancer and Nutrition (EPIC), Cox regression models yielded confounder-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for RCC incidence and mortality in relation to BMI modelled continuously and using restricted cubic splines. RCC-specific and all-cause mortality were evaluated among cases.

Results
During a mean follow-up of 14.9 years, 936 incident RCC cases were identified, 383 of whom died (278 due to RCC). Each 5 kg/m2 increment in BMI was associated with 27% and 46% higher RCC incidence and mortality (HRs=1.27, 95% CI 1.18-1.37 and 1.46, 95% CI 1.28-1.66, respectively). Comparing a BMI of 35 with 22 kg/m2, HRs for RCC incidence and mortality were 1.88 (95% CI 1.54-2.30) and 2.37 (95% CI 1.68-3.35), respectively. Among RCC cases, HRs per 5 kg/m2 increment in BMI were 1.22 (95% CI 1.07-1.41) for RCC-specific mortality and 1.18 (95% CI 1.04-1.34) for all-cause mortality. Similar, positive linear associations were evident for waist circumference and waist-to-hip ratio.

Conclusions
Obesity was associated with increased RCC incidence and mortality, and worse prognosis among cases.

Key messages
The kidney cancer-obesity paradox does not appear to be real. Higher adiposity is associated with an increased risk of incident and fatal RCC.
231The West Australian Burden of Disease Study 2015: mental health in Aboriginal West Australians
Authors: Hobday Michelle , Chapman Ann-Marie , Dixon Tracy , Fathima Parveen , Garcia Julianne , Serafino Stella , Stace-Winkles Nancy , Sun Wendy , Kirkland Laura 
Published: September 2021

Abstract

Background
Mental disorders represent a growing health problem: an estimated 45% of Australians experience a mental disorder in their lifetime. The Western Australian (WA) Burden of Disease study 2015 produced detailed data for sub-populations within the state to inform policy and planning. Using this, we describe the burden of mental, substance use disorders and self-inflicted injuries in the WA Aboriginal population.

Methods
The study generated estimates for over 200 diseases to create ranked disease-level estimates of burden in the WA Aboriginal population for the first time. Eleven individual conditions in the mental disorders disease group, and suicide and self-inflicted injuries were analysed.

Results
Mental disorders contributed 18% of Aboriginal male and 16% of Aboriginal female DALYs in WA. Among Aboriginal males, alcohol use disorders ranked 3rd among all diseases (ASR: 33.6 DALYs per 1,000 males). Among Aboriginal females, anxiety disorders ranked 3rd (ASR: 17.3 per 1,000 females). Suicide and self-inflicted injuries ranked 2nd among all diseases among Aboriginal males (ASR: 39.8 DALYs per 1,000 males) and 5th among Aboriginal females (ASR: 10.8 per 1,000 females).

Conclusions
The study highlighted the high burden of disease from mental disorders and self-inflicted injuries among Aboriginal West Australians: self-inflicted injuries, alcohol use disorders and anxiety disorders ranked in the top 10 of all diseases.

Key messages
Mental disorders contribute substantially to the disease burden in WA among the Aboriginal residents. The findings can inform health policy and planning around mental health in the Aboriginal population, as well as informing social and liquor licensing policy.