bluuebunny/crossref_metadata_2025_split huggingface dataset:
1220Barriers to care for people who use crystal methamphetamine
Authors: Kershaw Steph , Chapman Cath , Birrell Louise , Champion Katrina , Deen Hannah , Stapinski Lexine , Kay-Lambkin Honorary Frances , Teesson Maree , Newton Nicola 
Published: September 2021

Abstract

Background
Crystal methamphetamine (‘ice’) causes significant societal harm in Australia and is perceived by the public to be the drug of most concern nationally. Although effective treatments exist, it is estimated that only a third of people dependent on amphetamine-type stimulants receive treatment each year. Barriers to care may for people who use ice can include psychosocial (e.g., knowledge, attitudinal) and structural barriers. This study aimed to look at the perceived and actual barriers to care for Australians, as well as help-seeking behaviours among people who use ice.

Methods
An online survey was conducted among 2,110 Australians including people with lived experience, health workers, affected family members/friends and community members. All participants were asked about perceived barriers to care. People with lived experience were asked additional questions about help seeking.

Results
Attitudinal reasons were the highest perceived barrier to care among 63.1% of participants, followed by knowledge (21.9%). People with lived experience were more likely to endorse attitudinal barriers (OR 1.35), whereas health workers were more likely to endorse knowledge related barriers (OR 0.69). Among people with lived experience who had sought help, 74.5% had visited a counsellor/psychologist and 60.6% had asked help from a family member/friend.

Conclusions
Understanding and reducing barriers to care is essential to reduce the harms associated with the drug. It is important to support families and friends as they are often asked to help or support a loved one using ice.

Key messages
It is important to understand and reduce the perceived and actual barriers to care for people who use ice. This is essential to reduce the harms associated with the drug.
208The Effect of General vs. Regional Anesthesia on Early Postoperative Mortality in Hip Arthroplasty Patients
Authors: Khan Irfan , Noman Raihan , Markatia Nabeel , Pelaez Juan Ruiz , Vega Pura Rodriguez de la , Castro Grettel 
Published: September 2021

Abstract

Background
There is conflicting evidence in the literature regarding whether type of anesthesia (regional vs. general) is associated with postoperative mortality in patients undergoing hip arthroplasty. The present study compares mortality between general or regional anesthesia administered to patients undergoing either total (THA) or partial hip arthroplasty (PHA).

Methods
A retrospective cohort was assembled using the 2015-2016 American College of Surgeons National Surgical Quality Improvement Program database. Adult patients undergoing hip arthroplasty under general or regional anesthesia were included. Adjusted odds of 30 days all-cause postoperative mortality according to type of anesthesia were estimated by fitting multiple logistic regression models that included potential confounders and effect modifiers.

Results
A total of 60,897 patients were included. Given that the interaction between type of anesthesia and type of arthroplasty was statistically significant, separated models were fitted for each type of arthroplasty. There was no evidence of an association between type of anesthesia and postoperative mortality in hip arthroplasty patients regardless of whether the arthroplasty was partial (OR = 0.85; CI 0.59-1.22) or total (OR = 0.68; CI 0.43-1.08).

Conclusion
The overall postoperative mortality in adult hip arthroplasty patients is low. Our findings support that mortality is not different between patients receiving regional vs general anesthesia regardless of type of hip arthroplasty (total vs. partial).

Key Message
In patients undergoing total hip arthroplasty or partial hip arthroplasty, the use of general or regional anesthesia does not impact early postoperative mortality.
1202Examining the mental health effect of caring among adolescents using augmented inverse probability treatment weighting
Authors: King Tania , Singh Ankur , Disney George 
Published: September 2021

Abstract

Background
Caring exerts significant impacts on the lives of those providing care, however there has been limited quantitative analysis of the mental health impacts on young carers. This research aimed to estimate the effect of informal caring at age 14/15 years on mental health at age 18/19 years.

Methods
Data was drawn from Waves 5, 6, 8 (2012-2018) of the Longitudinal Study of Australian Children. Effects of caring on mental health were assessed using augmented inverse probability treatment weighting, with adjustment for potential confounders. Caring was assessed with both a binary (any caring vs none), and a three-category variable (no caring, less than daily caring, daily caring).

Results
In complete case models, binary caring at age 14/15 years was associated with poorer mental health at age 18/19 years, with an average treatment effect (ATE) of 1.10 (95%CI 0.37, 1.83). The ATE of daily caring compared to no caring at age 14/15 years of age was 1.94 (95%CI 0.48, 3.39), and caring less than daily (compared to no caring) was associated with a treatment effect of 0.83(95%CI 0.06, 1.61). Associations were robust to several sensitivity analyses.

Conclusions
These results suggest there is a mental health impact of caring in adolescence on mental health four years later.

Key messages
These results highlight the need for support for young carers. Such support is particularly essential for those providing more intensive caring.
745Probability-proportional-to-size cluster sampling as an effective methodology for large-scale participant recruitment
Authors: Kiran Suresh , Kamath Asha , Bellur Rajashekhar , Krishnan Gopee 
Published: September 2021

Abstract

Background
We demonstrate the utility of Probability-Proportional-to-Size Cluster Sampling (PPS-CS) to select participants/sites for large scale surveys.

Methods
Post ethical and administrative clearance, PPS-CS was carried-out to estimate the prevalence of ‘sublexical dyslexia’, a reading impairment in children from III-VII grades in Udupi district of India. Schools were regarded as clusters. By performing PPS-CS, calculated sample size of 1812 children was systematically recruited. Sampling frame: List of all 1256 schools in Udupi district was retrieved. Kannada medium schools were shortlisted, which yielded 128 schools later classified individually as urban or rural.

Results
Strength of schools was retrieved and cumulative strength (cs) was derived. With an average school size of 105 for rural and 98 for urban cluster, 18 schools were required to meet the sample size. Owing to a ratio of 3.5:1 of rural-to-urban students, 14 rural and 4 urban schools were selected. Ratio of ‘cs’ to ‘number-of-schools-required’ gave a sampling interval (SI) of 758 for rural, and 662 for urban cluster. A random number (R) was selected between one and SI. First school picked was that with cs &gt; =R. Second was that with cs &gt; =SI+R. The third was with cs &gt; =(SI+R at II school)+SI. Progressively, 18 schools were identified.

Conclusions
With disproportionate sizes of clusters, PPS-CS ensured that selected participants reflect population estimates accordingly. Prevalence of sublexical dyslexia in Udupi district was therefore accurately estimated using PPS-CS.

Key messages
Large-scale studies on healthcare or businesses may be effectively carried-out using PPS-CS!
1430Guideline-based cardiovascular disease risk assessment among Indigenous Australians in a general practice setting
Authors: Koye Digsu , Lamb Karen , Lee Ping-Wen , Kotevski Aneta , Haurat Javier , Turner Maureen , Ebsworth Gabrielle , Druce Tanya , Bryant Karen , Price Eloise , Taylor Georgia , Simpson Julie , Burchill Luke 
Published: September 2021

Abstract

Background
HealthGap is a population-based cohort study aiming to understand health inequities in cardiovascular disease (CVD) risk between Indigenous and non-Indigenous Australians. We examined guideline-based CVD risk assessment in Victoria.

Methods
NPS MedicineInsight, the largest Australian primary health care dataset, provided data on CVD risk factors (age, gender, smoking status, diabetes, systolic blood pressure (SBP), total and HDL cholesterol) and Aboriginal or Torres Strait Islander (Indigenous) status. The percentage of patients who had all risk factors measured was calculated and compared by Indigenous status.

Results
In total, 7,928 of 1,435,111 patients were classified as Indigenous. The percentage of patients with measured cholesterol was slightly lower for Indigenous (total cholesterol=31.4%, HDL=26.9%) than non-Indigenous patients (total cholesterol=35.6%, HDL=31.8%). However, more Indigenous patients had SBP measured (65.6% vs. 59.8%). Diabetes diagnosis was higher among Indigenous patients (6.2% vs. 3.6%).
There was a small difference in the proportions with all risk factors measured between Indigenous and non-Indigenous patients (24.1% vs. 26.6%). Among Indigenous patients aged at least 35 years who should have had their risk assessment measured, 41.9% had all risk factors measured, while 50.7% of the non-Indigenous Australians (aged ≥45 years) had all risk factors measured.

Conclusions
Overall, the proportion of people with all CVD risk factors measured was smaller for Indigenous compared to non-Indigenous people.

Key messages
Fewer than half of Indigenous Australians have CVD risk factors captured in a primary health care setting. This has implications for health care policy and programs seeking to improve CV health outcomes among Indigenous Australians.
575Factor affecting job satisfaction and organizational commitment among primary health care providers in Delhi, India
Authors: Kumar Pawan 
Published: September 2021

Abstract

Background
The purpose of present study was to explore the factors affecting job satisfaction and organizational commitment of primary health care providers working in Government health facilities of Delhi, India.

Methods
Study was conducted on a sample of 333 health care providers who were selected using multistage simple random sampling technique. Factor analysis of job satisfaction scale, statistical test like multiple regression, correlation tests were applied using SPSS version 18.

Results
The seven factors affecting job satisfaction emerged from the factor analysis which are; privileges attached with job, interpersonal relation and cooperation, working environment, patient relationship, organization facilities, career development and human resource issues. Nature of job whether regular or contractual explains 25.1% of variance in the job satisfaction of staff (R Square= 0.251, p = 0.000). Nature of job along with level of education of health care providers is affecting 26.5% of variance in job satisfaction (R Square= 0.265, p = 0.015). For organization commitment type of job whether regular or contractual is responsible for 44.7% of variance in the commitment (R square 0.447; p = 0.000) and experience of health care providers is affecting 29.0% of variance in commitment (R square= 0.290; p = 0.000). Other predictors of organization commitment are salary, job security, working environment, appreciation of work and career growth.

Conclusion
The findings strongly suggest that the mode of entry of employee, privileges, career growth and working atmosphere contribute substantially to the job satisfaction and organization commitment.

Key messages
Appropriate changes are required at the policy level to keep the human resource satisfied and committed to the organization keeping in consideration the factors responsible for them.
196Association of longitudinal lifestyle patterns with diabetes risk among sedentary and not-sedentary workers
Authors: Kuwahara Keisuke , Nakagawa Tohru , Yamamoto Shuichiro , Honda Toru , Hayashi Takeshi , Mizoue Tetsuya 
Published: September 2021

Abstract

Background
Evidence from observational studies is limited regarding longitudinal patterns of lifestyles and diabetes onset. In occupational settings, physical activity at work is an important factor to consider when implementing health promotion.

Methods
This is a cohort study among 25,646 workers without diabetes in Japan. We calculated lifestyle scores using 5 low-risk lifestyle factors: no-smoking, avoiding heavy alcohol use, engaging exercise, avoiding sleep deprivation, and keeping healthy weight, yielding the total score of 0 to 5 each year. We identified lifestyle patterns over 3 years by group-based trajectory modelling. Diabetes was defined by blood glucose, HbA1c, or self-report. Hazard ratios (95% confidence intervals) for incident diabetes were calculated using Cox regression.

Results
We detected five lifestyle patterns from a whole sample. During a mean follow-up of 6.6 years, 2,223 developed diabetes. Overall, healthier lifestyles were associated with a lower diabetes risk. Among sedentary workers, the multivariable-adjusted hazard ratios (95% confidence intervals) were 1.00 (reference) for persistently unhealthy pattern, 0.70 (0.60, 0.80) for persistently moderately healthy pattern, 0.45 (0.38, 0.53) for persistently mostly healthy pattern, 0.38 (0.28, 0.52) for improved to completely healthy pattern, and 0.24 (0.17, 0.32) for persistently completely healthy pattern. Similar results were obtained among not-sedentary workers.

Conclusions
Healthier lifestyles were associated with a lower risk of developing diabetes among participants who were sedentary at work and those who were not sedentary at work, respectively.

Key messages
Adherence to healthy lifestyles is important to prevent diabetes for working adults regardless of occupational physical activity level.
1150Changes in job security and mental health over 14 waves of a working population survey
Authors: LaMontagne Anthony D. , Punnett Laura , Too Lay San 
Published: September 2021

Abstract

Background & Methods
We examined whether job security improvements were associated with improvements in mental health in a large Australian nationally representative panel study. We used both within-person fixed effects (FE) and random effects (RE) regression to analyse data from 14 annual waves covering calendar years 2002—2015 (19,169 persons, 106,942 observations). Mental Health Inventory-5 scores were modeled in relation to self-reported job security (categorical, quintiles), adjusting for age, year, education, and job change in the past year.

Results
Both FE and RE models showed stepwise improvements in MHI-5 scores with improving job security, with stronger exposure-outcome relationships in the RE models and for men compared to women. The RE coefficients for improvements in job security in males were 2.06 [1.67, 2.46] for one quintile, steadily increasing for two- (3.94 [3.54, 4.34]), three- (5.82 [5.40, 6.24]), and four- (7.18 [6.71, 7.64]) quintile improvements. The FE model for males produced slightly smaller coefficients, reaching a maximum of 5.55 [5.06, 6.05]. Supplementary analyses investigated whether six waves of cumulative exposure to job security (higher value = higher security) predicted MHI-5 score (improvement in mental health) in the seventh wave: results showed a strong dose-response (beta cumulative security was 0.60 [0.53-0.68]), with the difference between lowest and highest values of exposure corresponding to a 14-point increase in MHI-5 score.

Conclusions
These analyses, with improved causal inference over previous observational research, showed that improving job security is strongly associated with decreasing depression and anxiety symptoms.

Key messages
Policy and practice intervention to improve job security could benefit population mental health.
353Do police-involved deaths increase homicide rates in the post-Ferguson Era? Evidence from 44 US cities
Authors: Lane Tyler 
Published: September 2021

Abstract

Background
Starting in 2014, homicide rates increased in several US cities, reversing a two-decade downward trend. A number of commentators blamed the events of Ferguson, Missouri, where police killed Michael Brown, leading to protests and greater scrutiny of similar events in other cities. It is still unclear whether effect is causal and what the mechanism would be.

Methods
Using the FBI’s Uniform Crime Reporting database, I derived 2011-2019 crime data from 44 US cities where protests followed a local police-involved death. The main outcome was homicide. Assaults are potentially similar as a conflict-resolution strategy, though reporting is more discretionary than homicides. Differences in effect between homicide and assault were used as a proxy for underreporting and an indicator legal cynicism. Effects were tested using interrupted time series and combined with meta-analyses. Meta-regressions were used to test the moderating effects of external investigations and sociodemographic factors.

Results
Homicides increased 26% (99% CI: 15%, 36%). Assaults also increased, though the effect was 15% lower than the homicides (-27%, -4%). No tested factor significantly effects.

Conclusions
Where police-involved deaths lead to protests, homicide rates increase. The findings support de-legitimisation of police as a causal mechanism, but not de-policing.

Key messages
Police-involved deaths can lead to increased homicides. Cities where police-community tensions are already high may be particularly vulnerable to homicide rate increases following police-involved deaths.
229Step-downs reduce workers’ compensation payments to encourage return to work. Are they effective?
Authors: Lane Tyler , Sheehan Luke , Gray Shannon , Collie Alex 
Published: September 2021

Abstract

Background
Workers’ compensation systems throughout Australia implement “step-downs,” which cut the amount paid to injured workers after they have received benefits for several months. Though initially introduced to control rising insurance premiums, step-downs are currently justified as an incentive return to work. Whether they have this effect has never been formally tested.

Methods
Using administrative claims data, we applied a regression discontinuity study design to test whether step-downs affected weekly scheme exit rates, a proxy for return to work, within eight state, territory, and Commonwealth workers’ compensation systems. We also examined effects by injury type (fractures, musculoskeletal, mental health, and other trauma). To derive generalised effects, we combined results using meta-analyses and conducted meta-regressions to determine whether timing or magnitude of step-downs significantly moderated effects.

Results
Step-downs reduced scheme exit by 0.86 percentage points (95% CI: -1.45, -0.27). Neither timing nor magnitude of step-downs was a significant effect moderator. There were significant effects in fractures (-0.84, 95% CI: -1.61, -0.07) and sensitivity analysis suggested possible effects within mental health and musculoskeletal conditions.

Conclusions
The negative effects suggest some workers’ compensation recipients anticipate step-downs and return to work early to avoid a reduction in income. However, the effects were small and suggest step-downs have marginal practical significance. We conclude that step-downs are generally ineffective as a return to work policy initiative.

Key messages
Reducing the amount of compensation paid to injured workers has a minor incentivising effect on their return to work rates.
1238Estimating the non-specific effects of seasonal influenza vaccine on RSV-hospitalisations in children
Authors: Le Huong , Blyth Christopher , Gidding Heather , Snelling Tom , Fathima Parveen , Moore Hannah 
Published: September 2021

Abstract

Background
Seasonal influenza vaccine is effective against influenza hospitalisations, but little is known about non-specific effects on other respiratory pathogens with similar seasonal patterns. We aimed to assess the causal impact of seasonal influenza vaccine on laboratory-confirmed hospitalisations for respiratory syncytial virus (RSV) in children using an instrumental variable (IV) strategy.

Methods
We used population-based probabilistically linked data on births, childhood immunisations, deaths, hospitalisations, perinatal and statewide microbiology data (2000-2013) in Western Australia (WA). Our analysis cohort included children up to age 7 years. We exploited WA’s unique preschool influenza vaccination policy commencing in 2008 and used this as an instrument for vaccination status. We estimated a system of two simultaneous probit equations: determinants of influenza vaccine uptake, and determinants of RSV-confirmed hospitalisation.

Results
Influenza vaccine coverage was low prior to 2008 but increased to 33.7% in children aged 6-23 months in 2009. RSV-hospitalisations ranged from 3.5/1000 children (12-23 months) to 6.4/1000 (6-12 months). Receipt of seasonal influenza vaccine reduced RSV-hospitalisations in the population cohort of children aged &lt;2 years by an average of 0.21% in the same year (p &lt; 0.001).

Conclusions
To our knowledge, this is the first analysis utilising an IV estimation strategy to assess the impact of influenza vaccine on RSV-hospitalisations. We estimated a small, but highly statistically significant impact that warrants further investigation using contemporary data.

Key messages
RSV is a leading cause of childhood morbidity. The role of influenza vaccine offering cross protection to RSV could be further explored prior to RSV vaccines being commercially available.
1376Modern concepts in the handling and reporting of missing data
Authors: Lee Katherine , Carpenter James , Little Roderick , Nguyen Cattram , Cornish Rosie 
Published: September 2021

Abstract

Focus and outcomes for participants
Missing data are ubiquitous in observational studies, and the simple solution of restricting the analyses to the subset with complete records will often result in bias and loss of power. The seriousness of these issues for resulting inferences depends on both the mechanism causing the missing data and the form of the substantive question and associated model. The methodological literature on methods for the analysis of partially observed data has grown substantially over the last twenty years, and although there is increasing guidance on how to handle missing data, practice is changing slowly and misapprehensions abound, particularly in observational research. Importantly, the lack of transparency around methodological decisions regarding the analysis is threatening the validity and reproducibility of modern research. In this symposium leading researchers in missing data methodology will present practical guidance on how to select an appropriate method to handle missing data, describe how to report the results from such an analysis and describe how to conduct sensitivity analyses in the multiple imputation framework.

Rationale for the symposium, including for its inclusion in the Congress
One of the sub-themes of WCE 2021 is “Translation from research to policy and practice”. Although there is a growing body of literature surrounding missing data methodology, evidence from systematic reviews suggests that missing data is still often not handled appropriately. If practice is to change, it is important to educate applied researchers regarding the available methodology and provide practical guidance on how to determine the best method for handling missing data. An important part of this is providing guidance on the reporting of results from analyses with missing data. This is particularly pertinent given the current emphasis on reproducibility of research findings. In this symposium we bring some of the latest research from the Missing Data Topic Group of the STRengthening Analytical Thinking for Observational Studies (STRATOS) initiative whose aim is to provide accessible and accurate guidance in the design and analysis of observational studies in order to increasie the reliability and validity of observational research.

Presentation program

Names of presenters