Electoral Roll Research Articles

Associated Factors of Drinking Prior to Recognising Pregnancy and Risky Drinking among New Zealand Women Aged 18 to 35 Years.

Nearly half of all pregnant women in the Western world drink prior to recognising pregnancy. The current study aimed to investigate the factors associated with drinking prior to recognising pregnancy among pregnant women and factors associated with risky drinking among nonpregnant sexually active women. The study was a cross-sectional survey of a random sample of women aged 18 to 35 years (n = 1062) selected from the New Zealand electoral roll. Pregnant women (currently pregnant: n = 65; previously pregnant: n = 202) who were risky drinkers and who smoked in the year prior to pregnancy had five times the odds (p < 0.01) and women who planned their pregnancy (p = 0.05) and who used a community service card (p = 0.004) had less than half the odds to drink prior to recognising pregnancy than their respective counterparts. Among sexually active nonpregnant women who consumed alcohol, those who smoked in the year prior to the survey and those who drank for social reasons, for mood enhancement or coping reasons had higher odds of being risky drinkers (p < 0.05). Addressing risky drinking, especially in social settings, and smoking among women of peak childbearing age may mitigate the potential risk of drinking prior to recognising pregnancy.

Taming Executive Authoritarianism in Africa: Some Reflections on Current Trends in Horizontal and Vertical Accountability

Executive lawlessness has been one of the major sources of the crisis of constitutionalism in Africa. After a 9 year tenure marked by allegations of corruption and complicity in the capture of the state by an Indian business family, the South African president, Jacob Zuma was forced to resign on 14 February 2018. This came hard on the heels of the rare and bold decision by the Kenyan Supreme Court in September 2017, to declare null and void the results of a presidential election that resulted in the incumbent’s winning a second term. Meanwhile, in the Democratic Republic of Congo, dozens of people have died in protests as Joseph Kabila refuses to step down or hold elections after the end of his second and final term, claiming that this is due to lack of funds and logistical obstacles such as an incomplete and unreliable electoral roll. These and numerous other recent events have not only called into question the prospects for sustaining the democratic transition from the corrupt, repressive and incompetent authoritarian governance of yesteryear that Africa began to witness in the 1990s. More pertinently, this has raised the question of whether the accountability mechanisms in the constitutions that African states revised or adopted in the 1990s and thereafter, are sufficiently effective for checking the continent’s unruly executives? Africa’s ‘big men’ and their cronies are well known for their insatiable capacity to misuse their privileged positions to enrich themselves and their supporters almost with impunity. The Zuma case, however, underscores just how challenging it is to enforce the fundamental principle that all citizens, regardless of their status, are not only equal before, and bound to obey and act in accordance with the law, but that the law also applies to all without fear, favour or prejudice. This paper examines, from a comparative perspective, the manner in which attempts are being made to ensure that the executive branch, especially presidents, are accountable for their actions and inactions. The issue of executive accountability is situated within the broader context of the extensive powers usually conferred on the executive branch. The operation of two main accountability mechanisms and institutions to check against abuses of executive power: horizontal accountability processes and vertical ones, adopted in African jurisdictions, are critically reviewed. The paper shows that, in spite of the numerous innovative measures and institutions introduced to check abuse of powers in Africa, executive accountability is generally in decline. More needs to be done to sustain the transition to transparent and accountable systems of governance on the continent.

Association between plasma phospholipid omega-3 polyunsaturated fatty acids and type 2 diabetes is sex dependent: The Hunter Community Study

Chronic inflammation drives the development of insulin resistance and type 2 diabetes. Long-chain omega-3 polyunsaturated fatty acids (LCn-3PUFA) eicosapentaenoic acid (EPA, c20:5n-3) and docosahexaenoic acid (DHA, c22:6n-3) may protect against type 2 diabetes development. The aim of this current study is to determine whether LCn-3PUFA status is associated with type 2 diabetes in the Hunter Community Study. Men and women aged 55-85 years were randomly selected from the electoral roll and invited to participate. Participants were included in the current study if they had plasma phospholipid fatty acid composition data available and diabetes status could be determined. LCn-3PUFA status was determined by fatty acid composition of plasma phospholipids (EPA+DHA, %,w/w). Diabetes was determined according to World Health Organisation criteria. Insulin was measured in n=251 participants and HOMA-IR calculated. In total, n=2092 (diabetes: n=249) participants were included. After adjusting for confounders of diabetes, LCn-3PUFA status was inversely associated with diabetes in overweight/obese females (OR [95%CI]: 0.90 [0.80, 1.00], p=0.045) but not males (p-interactionsex=0.041). Overweight/obese females with diabetes had significantly lower levels of DHA than those without diabetes (mean difference [95%CI]:-0.53 [-0.87,-0.20], p=0.002), with no difference in EPA. LCn-3PUFA was inversely associated with HOMA-IR (r=-0.175, p=0.005). This study provides further evidence of a sex-dependent association between LCn-3PUFA and type 2 diabetes. Causal pathways between LCn-3PUFA and type 2 diabetes merits delineation.

Occupation and motor neuron disease: a New Zealand case–control study

ObjectivesTo assess associations between occupation and motor neuron disease (MND).MethodsWe conducted a population-based case–control study with cases (n=321) recruited through the New Zealand Motor Neurone Disease Association and hospital discharge...

Anti-fracture efficacy of zoledronate in subgroups of osteopenic postmenopausal women: secondary analysis of a randomized controlled trial.

We recently reported that the administration of zoledronate every 18months to osteopenic older women reduces the incidence of fractures. Here, we present a more detailed analysis of that trial to determine whether baseline clinical characteristics impact on the anti-fracture efficacy of this intervention. This is a prospective, randomized, placebo-controlled, double-blind trial in osteopenic postmenopausal women aged≥65years, to determine the anti-fracture efficacy of zoledronate. 2000 women were recruited using electoral rolls and randomized to receive 4 infusions of either zoledronate 5mg or normal saline, at 18-month intervals. Each participant was followed for 6years. Calcium supplements were not supplied. Fragility fractures (either vertebral or nonvertebral) occurred in 190 women in the placebo group (227 fractures) and in 122 women in the zoledronate group (131 fractures), odds ratio (OR) 0.59 (95%CI 0.46, 0.76; P<0.0001). There were no significant interactions between baseline variables (age, anthropometry, BMI, dietary calcium intake, baseline fracture status, recent falls history, bone mineral density, calculated fracture risk) and the treatment effect. In particular, the reduction in fractures appeared to be independent of baseline fracture risk, and numbers needed to treat (NNT) to prevent one woman fracturing were not significantly different across baseline fracture risk tertiles. The present analyses indicate that the decrease in fracture numbers is broadly consistent across this cohort. The lack of relationship between NNTs and baseline fracture risk calls into question the need for BMD measurement and precise fracture risk assessment before initiating treatment in older postmenopausal women.

New Caledonia Remains French for Now: The Referendum of 4 November 2018

ABSTRACTNew Caledonia’s 4 November 2018 referendum confronted voters with a divisive choice between independence and continuation of the status quo. It did not offer another potential option of ‘associated independence’, though that had been extensively discussed in the 1980s and rejected by loyalists because it entailed too much independence and by Kanak because there was too much association. This paper reviews the referendum outcome, and examines the controversies about the make-up of the special electorate for that contest and the electoral roll for provincial and French national elections. It argues that 30 years of dialogue about decolonization have not succeeded in reaching agreement on a consensual future and that there is a risk that the political map of New Caledonia remains frozen. What is needed is not further institutional reform or so-called ‘internal decolonization’ but a crossed interethnic majority in Congress, and a halt to French efforts to strengthen the anti-independence demographic and electoral majority.

High-Sensitivity Cardiac Troponin I Improves Cardiovascular Risk Prediction in Older Men: HIMS (The Health in Men Study).

BackgroundThe Framingham Risk Score estimates the 10‐year risk of cardiovascular events. However, it performs poorly in older adults. We evaluated the incremental benefit of adding high‐sensitivity cardiac troponin I (hs‐cTnI) to the Framingham Risk Score.Methods and ResultsThe HIMS (Health in Men Study) is a cohort study of community‐dwelling men aged 70 to 89 years in Western Australia. Participants were identified from the electoral roll, with a subset undergoing plasma analysis. Hs‐cTnI (Abbott Architect i2000SR) was measured in 1151 men without prior cardiovascular disease. The Western Australia Data Linkage System was used to identify incident cardiovascular events. After 10 years of follow‐up, 252 men (22%) had a cardiovascular event (CVE+) and 899 did not (CVE–). The Framingham Risk Score placed 148 (59%) CVE+ and 415 (46%) CVE– in the high‐risk category. In CVE– men, adding hs‐cTnI affected the risk categories of 244 (27.2%) men, with 64.8% appropriately reclassified to a lower and 35.2% to a higher category, which decreased the number of high‐risk men in the CVE– to 39%. In CVE+ men, adding hs‐cTnI affected the risk categories of 61 (24.2%), with 50.8% appropriately reclassified to a higher and 49.2% to a lower category and 82.5% remaining above the 15% risk treatment threshold. The net reclassification index was 0.305 (P<0.001). Adding hs‐cTnI increased the C‐statistic modestly from 0.588 (95% CI, 0.552–0.624) to 0.624 (95% CI, 0.589–0.659) and improved model fit (likelihood ratio test, P<0.001).ConclusionsAdding hs‐cTnI to the Framingham Risk Score provided incremental prognostic benefit in older men, especially aiding reclassification of individuals into a lower risk category.

The influence of orthodontic treatment on dental caries: An Australian cohort study.

To assess the influence of orthodontic treatment on long-term caries experience in 30-year-old South Australians. The research hypothesis that was tested was that those with previous orthodontic treatment would have lower caries experience. In 2005-2006, a sample of 1859 30-year-olds from Adelaide, South Australia, who comprised 47% of participants who had previously taken part in an oral epidemiology study in 1988-1989, were traced from the Australian electoral roll and invited to participate in a cross-sectional study investigating long-term dental health outcomes. Participants completed a questionnaire that collected information on socio-demographic characteristics, dental health behaviours and receipt of orthodontic treatment. This was followed by clinical examination. The outcome variables were the summed decayed, missing and filled teeth (DMFT) score, and its individual components. Data were analysed using negative binomial regression. The response rate for the questionnaire was 34% (n=632). There were no systematic differences between those who were followed up and those who were not followed up. Clinical data for 448 participants were available for analyses, representing 24% of the originally contacted individuals. By the age of 30, over a third of participants had received orthodontic treatment. Regardless of initial malocclusion classification, orthodontically treated participants had a lower DMFT score at age 30 but this did not reach statistical significance. Adjusted models controlling for socio-demographic, dental health behaviour and malocclusion status showed no associations between orthodontic treatment and decayed (Exp B: 1.00, 95% CI: 0.72-1.40), missing (Exp B: 1.00, 95% CI: 0.59-1.69), or filled teeth (Exp B: 1.18, 95% CI: 0.93-1.51) or overall DMFT (Exp B: 1.12, 95% CI: 0.88-1.41). There was no difference in the long-term caries experience of South Australians aged 30years based on past orthodontic treatment. Our study does not support the contention that those treated orthodontically have better dental health later in life.

National Pharmacy Boards Elections 2019: Closure of electoral roll and deadline for updating voting preferences

National Pharmacy Boards Elections 2019: Closure of electoral roll and deadline for updating voting preferences

Consequences of the Electoral System in Polish Municipalities – Pathologies and Abuses

Pathologies and abuses accompany elections and are connected with the electoral system both in its narrow and broad sense. Moreover, they stem from a human nature and a degree of democratic principles consolidation. Cohabitation is conditioned by the electoral system and, in the case of the proportional allocation of seats, it arises more often than in the majority system with single member constituencies. The phenomenon itself is not always pathological. However, such an adverse situation develops when it comes to clashes, neither substantive nor creative, between the municipal bodies and, in consequence, the interests of the local community are jeopardised. Elections at the municipal level are also accompanied by other pathologies and abuses including: coercing votes when voting by proxy, adding voters to an electoral roll, bringing residents to a polling place, paying for one’s votes, preying on the naïvety of voters which can take grotesque forms or brutalising an election campaign caused by the mediatisation of local policy. The above-mentioned phenomena were examined and presented in the paper based on the analysis of statistical data, articles from the local press and, most essentially for the discussed subject, a rich material collected thanks to the in-depth interviews conducted by the authors.

Dublin’s Lodger Phenomenon in the Early Twentieth Century

Lodging and boarding were well-established housing options which played an important economic and social role in early twentieth-century cities, yet there has been little academic study of the phenomenon in an Irish context. For many people arriving to Dublin in search of work, as well as for adults who were not in a position to establish a separate household, lodging was an important accommodation choice. Offering lodgings was also economically beneficial to householders. Drawing on a range of sources, including census returns, city electoral rolls, newspaper and other archival sources, this article will examine the demographic and socio-economic profile of lodgers and the households in which they resided in Dublin in the early twentieth century. A wide variety of arrangements and durations of lodging is revealed for the period centred on the 1911 census, suggesting that this form of accommodation appealed to a diverse range of individuals due to their economic or family circumstances, or need for mobility.

Association between DNA methylation of the KITLG gene and cortisol levels under stress: a replication study

A recent study reported for the first time, that DNA methylation of the KITLG gene mediates the association between childhood trauma and cortisol stress reactivity. Our study aimed to provide the first independent replication of these findings. ESPRIT is a prospective study of community-dwelling participants (age ≥ 65), randomly selected from the electoral rolls of the Montpellier district, in France. Clinical depression was assessed using the Mini-International Neuropsychiatric Interview (MINI, French version 5.00), and the Centre for Epidemiological Studies Depression Scale (CES-D). Experiences of childhood adversity were ascertained via a 25-item questionnaire. Morning, evening, and diurnal salivary cortisol was measured under basal and stress conditions and determined using direct radioimmunoassay analysis. DNA methylation of the KITLG gene was quantified in whole blood using the SEQUENOM MassARRAY EpiTYPER platform. A significant negative association was observed between KITLG DNA methylation and both morning cortisol (β = −1.846 ± 0.666, p = .007) and diurnal cortisol (area under curve [AUC]) (β = −19.429 ± 8.868, p = .031) under a stress condition. However, only the former association was significant after correcting for multiple testing. Further, this association remained after adjusting for age, sex, and depression status. No significant association was observed between childhood trauma and KITLG DNA methylation in this older population. This study provides support for an association between KITLG methylation and stress cortisol levels, suggesting that DNA methylation of this gene may play a role in the longer term regulation of the stress system.Lay summary The significant negative association between KITLG DNA methylation and morning cortisol, measured under a stressful condition, suggests that individuals with higher KITLG methylation will secrete lower levels of cortisol whilst under stress.

Can Cross-Sector Partnerships Increase Breast Cancer Screening in Hard-to-Reach Migrant Populations?

Background and context: BreastScreen Victoria (BSV) provides free breast screening to women aged 40+; targeting women aged 50-74. The program reduces breast cancer-related deaths by up to 28%. BSV aims to ensure equitable participation for all women in the target age; however there are large disparities in screening rates for different subpopulations. Emerging migrant women participate in breast screening at lower rates than the general population. These women face complex barriers including cultural factors, low health literacy, and access. BSV identified cross-sector partnerships, with local trusted organizations who engage with emerging migrant women, as an approach to tackle the multidimensional problems in screening inequalities. Aim: Through cross-sector partnerships BSV aims to bring together diverse skills, knowledge and resources for more effective health promotion outcomes, including: 1. Increasing awareness of breast screening in emerging migrant communities, 2. Providing a culturally safe environment for women to access breast screening. Strategy/Tactics: BSV partnered with organizations beyond the traditional health sector. One key partnership is with AMES Australia, who provide settlement services for refugees and migrants. The main approach of this model is two-way capacity building between organizations. BSV built the capacity of AMES to deliver BreastScreen's key messages, and promote screening to eligible women accessing their service. This included training for staff, resource development/sharing, and support. AMES built the capacity of BSV by providing insight into barriers for women they engage, and guidance adapting traditionally clinical environments ensuring cultural safety. To date BSV has undertaken screening initiatives with AMES in 2 Melbourne locations. Outcomes: - Migrant women are introduced to breast screening by a trusted organization - BSV's key messages are delivered in a culturally appropriate manner - Development of sustainable skills, structures and resources in both organizations - Utilization of AMES relationship with their clients to engage women who BSV may not reach -not on the Victorian Electoral Roll - 6 group bookings with specific languages groups - Familiar case worker and in person translator supporting group bookings - Engaging mainly first time screeners who may not have accessed a breast screen - Overcoming cultural, language, and health literacy barriers - Tailored appointments for groups and walk-ins. What was learned: A lack of tailored strategies to engage women in breast screening compounds barriers for migrant women. Cross-sector partnerships increase the efficiency of systems that impact health by making the best use of different but complementary resources. Collaborations, joint resourcing and planned action should be considered ongoing practice, particularly for disengaged populations, to address the many determinants of health that lie outside the reach of the health system.

A comparison of perceptions of nuts between the general public, dietitians, general practitioners, and nurses.

BackgroundNut consumption at the population level remains low despite the well-documented benefits of their consumption, including their cardioprotective effects. Studies have suggested that advice from health professionals may be a means to increase nut consumption levels. Understanding how nuts are perceived by the public and health professionals, along with understanding the public’s perceptions of motivators of and deterrents to consuming nuts, may inform the development of initiatives to improve on these low levels of consumption. The aim of this cross-sectional study was to compare perceptions of nuts among three groups of health professionals (dietitians, general practioners, and practice nurses) and the general public in New Zealand (NZ), along with motivators of and deterrents to consuming nuts amongst the general public and their experiences of receiving advice around nut consumption.MethodsThe NZ electoral roll was used to identify dietitians, general practitioners (GPs), and practice nurses, based on their free-text occupation descriptions, who were then invited to complete a questionnaire with 318, 292, and 149 respondents respectively. 1,600 members of the general public were randomly selected from the roll with 710 respondents. Analyses were performed using chi-squared tests to look at differences in categorical variables and linear regression for differences in other variables between the four survey groups.ResultsAlthough there were significant differences between the four groups regarding the perceptions of nuts, in general there was agreement that nuts are healthy, high in protein and fat, are filling, and some nuts are high in selenium. We noted frequent agreement that the general public participants would consume more if nuts: improved health (67%), were more affordable (60%), or improved the nutrient content (59%) and balance of fats (58%) within their diets. Over half the respondents reported they would eat more nuts if they were advised to do so by a dietitian or doctor, despite less than 4% reporting they had received such advice. The most frequently selected deterrents to increasing nut consumption were: cost (67%), potential weight gain (66%), and leading to eating too much fat (63%).DiscussionIt is concerning that so few among the general public report receiving advice to consume more nuts from health professionals, especially given their apparent responsiveness to such advice. Health professionals could exploit the motivators of nut consumption, while also addressing the deterrents, to promote nut intake. These factors should also be addressed in public health messages to encourage regular nut consumption among the public. Educational initiatives could also be used to improve the nutritional knowledge of GPs and practice nurses with regard to nuts, although even dietitians were unsure of their knowledge in some cases.

‘Mind your Moles’ study: protocol of a prospective cohort study of melanocytic naevi

IntroductionHaving many melanocytic naevi or ‘moles’ on the skin is the strongest predictor of melanoma; thus, much can be learnt from investigating naevi in the general population. We aim to...

A comparison of methodologies: sibling identification using a relational versus a graph-based approach

IntroductionThe detection of siblings is an important pre-requisite for many research problems, yet is traditionally difficult or time-consuming owing to the way linked data is conventionally stored. We compare the methodology and results for an identification of siblings by SANT DataLink using a legacy relational approach and a graph-based approach.&#x0D; Objectives and ApproachAn existing project involving the identification of sibling clusters using relational techniques was replicated using the same core data in SANT DataLink’s Next Generation Linkage Managment System (NGLMS) which is graph-based. Data is stored in the NGLMS using richer relationships than just 'is W% similar to' or 'is part of group N'. Birth data was separated into children and parents and explicit child/parent relationships recorded. When coupled with electoral roll data using probabilistic and deterministic linkage, sibling structure can be identified by performing network traversal via parents, e.g.&#x0D; crecord—[MOTHER]⟶mrecord—[IS_SIMILAR_TO]⟶mrecord*⟵[MOTHER]—crecord*&#x0D; i.e. find the mother, find that mother’s cluster, find all children related to that cluster. The resulting records are siblings.&#x0D; ResultsA graph-based approach enabled the methology of 'finding siblings' to be more clearly described and communicated by mirroring genealogical structures natively within in the data. Comparable results were achieved in a shorter time with less manual effort using the same underlying data. Generating sibling clusters from the graph-based data required less manual intervention and review as explicit PARENT/CHILD relationships were stored in the data and able to be quickly traversed to assemble familial units and thus siblings. A focus on automated linkage quality rather than manual review was facilitated by the approach. Anomalous structures requiring detailed review, such as multiple fathers and mothers of a single child, were trivially identifiable and so manual effort was focussed on actions where a higher return in terms of end-product quality could be achieved.&#x0D; Conclusion/ImplicationsStoring data in a representation which more closely resembles the the underlying real-world situation allows greater fidelity with respect to data modeling. This in turn, enables the asking of richer questions and makes the answering of such questions much easier.

Analysing complex linked administrative data in health services research: Issues and solutions

IntroductionLinked administrative data are increasingly being used to evaluate the impact of health policy on health-service use/cost because they can comprehensively capture whole of population interactions with the health system. These analyses are complex comprising unbalanced panels and are at risk of endogeneity and associated problems.&#x0D; Objectives and ApproachWe evaluated the impact of changes in regularity of general practitioner contact on diabetes related hospitalisation before and after care coordination policies using whole of population, person-level linked primary care, hospital, Electoral Roll and death records. Complex panel random-effects modelling techniques were required due to the unbalanced structure of the data (individuals could exit and re-enter the study repeatedly), over-dispersion and high proportion of zeros, changes in availability of tests (ascertainment bias), the likelihood of prior health service use influencing the dependent variable (initial conditions and simultaneity/reverse causality bias) and likely correlation of observed and unobserved variables.&#x0D; ResultsMultivariable zero-inflated negative binomial and Cragg-hurdle clustered robust regression, which include separate components to model zero and non-zero outcomes, were required for these data. Mundlak variables (group-means of time-varying variables) were used to relax the assumption in the random-effects estimator that the observed variables were uncorrelated with the unobserved ones. Prior health service use was adjusted for using 4-year lags of GP contact and one-year lag of hospitalisation. The initial value of the dependent variable resolved the “initial condition” problem. Ascertainment bias was addressed using the number of years available for identification for each person as a covariate. AIC/BIC values were used to identify the best model. We found that more regular GP contact was associated with fewer hospitalisations, however this attenuated over time.&#x0D; Conclusion/ImplicationsAvailability of linked data, together with increases in computing power, has vastly increased its potential for use. This has also increased the complexity of analyses being undertaken necessitating recognizing and addressing problems, such as endogeneity, that arise due to the observational nature of the studies undertaken.

Self-harm hospitalised morbidity and mortality risk in Australia using a matched population-based cohort

IntroductionPrior and repeated self-harm hospitalisations are common risk factors for suicide. However, few studies have accounted for pre-existing comorbidities and prior hospital use when quantifying the burden of self-harm.&#x0D; Objectives and ApproachTo quantify hospitalisation in the 12 months preceding and re-hospitalisation and mortality risk in the 12 months post a self-harm hospitalisation. A population-based matched cohort study of individuals ≥18 years using linked hospitalisation and mortality records from four Australian states. Self-harm was identified using a principal diagnosis of injury (S00-T75 or T79) and an external cause of self-harm (X60-X84). The index self-harm hospitalisation was identified and 12-month pre- and post-index injury health service use was examined. The non-injured comparison cohort was randomly selected from the electoral roll and was matched 1:1 on age, gender, and postcode of residence. Comorbidities were identified using diagnosis classifications with a 1-year lookback. Negative binomial regression was used to quantify associations between self-harm and counts of hospital admissions 12-months post the index hospitalisation using rate ratios and 95%CIs.&#x0D; ResultsThere were 11,597 individuals with a self-harm hospitalisation in New South Wales, South Australia, Queensland or Tasmania with a matched comparison. Mean age was 38.6 years (SD=14.9) and 57.6% were female. The self-harm cohort had a higher proportion of Charlson comorbidities, mental health diagnoses, alcohol misuse and drug-related dependence than their matched counterparts. The self-harm cohort experienced a higher proportion of health service use in the 12-months preceding (20.5% vs 10.1%) and post (21.2% vs 10.6%) the index admission and a higher mortality rate (2.9% vs 0.3%) than their matched counterparts. The adjusted rate ratios (ARR) for hospital readmission were highest for females (ARR: 2.86; 95% CI: 2.33-3.52) and individuals aged 55-64 years (ARR: 3.96; 95%CI: 2.79-5.64).&#x0D; Conclusion/ImplicationsImproved hospitalisation burden quantification for self-harm can inform resource allocation for intervention and after care services for individuals at-risk of repeated self-harm. Better assessment of at-risk self-harm behaviour, appropriate referrals and improved post-discharge care, focusing on care continuity is needed.

Sunscreen Use and Melanoma Risk Among Young Australian Adults

There are limited data among young adults on sunscreen use during childhood and adulthood and on the association of sunscreen use with melanoma risk. To assess correlates of early-life sunscreen use and the association between sunscreen use and risk of cutaneous melanoma before age 40 years. This population-based, case-control family study analyzed Australian Melanoma Family Study data for persons with questionnaire data on sunscreen use collected by interview from 2001 to 2005 across 3 states in Australia, representing two-thirds of the country's population. Case participants (aged 18-39 years) had confirmed first primary melanoma. Siblings of case participants were included, and case participants without a sibling control were excluded. Unrelated controls (aged 18-44 years) were recruited from the electoral roll or were a spouse, partner, or friend nominated by case participants. Data analyses were conducted from October 2017 to February 2018. Self- and parent-reported sunscreen use, sun exposure, and other candidate risk factors during childhood and adulthood. Logistic regression analyses adjusted for potential confounders were used to estimate odds ratios (ORs) for melanoma and for correlates of sunscreen use. Participation was 629 of 830 contactable cases (76%) (629 of 1197 overall [53%]), 240 of 570 contactable controls (42%) from the electoral roll (240 of 1068 overall [23%]), and 295 of 371 nominated spouse or friend controls (80%); analysis incuded 603 cases and 1088 controls. The median (interquartile range) age was 32 (28-36) years for 603 cases, 35 (30-38) years for 478 unrelated controls, and 34 (29-38) years for 610 sibling controls. There were more women than men (range, 57%-62%) in all groups, approximately 40% (range, 39%-43%) of participants had a university education, and most participants (range, 58%-73%) had British/northern European ethnicity. Risk of melanoma was less with higher use of sunscreen in childhood (OR for highest vs lowest tertiles, 0.60; 95% CI, 0.42-0.87; P = .02 for trend) and across the lifetime (OR, 0.65; 95% CI, 0.45-0.93; P = .07 for trend). Subgroup analyses suggested that the protective association of sunscreen with melanoma was stronger for people reporting blistering sunburn, receiving a diagnosis of melanoma at a younger age, or having some or many nevi. Total lifetime sun exposure was unrelated to melanoma risk (OR for highest vs lowest tertile, 0.97; 95% CI, 0.66-1.43; P = .94 for trend). By contrast, total sun exposure inversely weighted by sunscreen use (as a measure of sun exposure unprotected by sunscreen) was significantly associated with melanoma risk (OR, 1.80; 95% CI, 1.22-2.65; P = .007 for trend) and appeared stronger for people having lighter pigmentation or some or many nevi or using sunscreen to stay longer in the sun. Regular users of sunscreen were more likely to be female, younger, and of British or northern European ancestry and to have higher educational levels, lighter skin pigmentation, and a stronger history of blistering sunburn. Our findings provided evidence that regular sunscreen use is significantly associated with reduced risk of cutaneous melanoma among young adults and identified several characteristics associated with less sunscreen use.

Participación electoral y transnacionalismo político. Los ciudadanos caboverdianos residentes en la Argentina y su voto en las elecciones presidenciales de Cabo Verde

Cabo Verde desde 1991 realiza elecciones democráticas en los tres niveles de poder político: municipales, legislativas y presidenciales. A partir de la revisión constitucional de 1992 los caboverdianos no residentes en el archipiélago, con edad igual o superior a los 18 años que estén registrados en los padrones electorales, tienen derecho al sufragio.&#x0D; Los caboverdianos residentes en la Argentina, como parte del denominado “circuito electoral de la diáspora”, han participado en las tres últimas elecciones presidenciales.&#x0D; El propósito de este trabajo es referirnos de un modo específico, al transnacionalismo político en relación con el voto de la comunidad caboverdiana en el extranjero en general y en la Argentina en particular, en vinculación con el ejercicio de la ciudadanía y la identidad.&#x0D; Palabras clave: voto, África, Argentina, Cabo Verde, transnacionalismo, ciudadanía, iden-tidades.