Health-related Events Research Articles

An Evaluation of Syndromic Surveillance-Related Practices Among Selected State and Local Health Agencies.

Syndromic surveillance consists of the systematic collection and use of near real-time data about health-related events for situational awareness and public health action. As syndromic surveillance programs continue to adopt new technologies and expand, it is valuable to evaluate these syndromic surveillance systems and practices to ensure that they meet public health needs. This assessment's aim is to provide recent information about syndromic surveillance systems and practice characteristics among a group of state and local health departments. Information was obtained between November 2017 and June 2018 through a telephone survey using an Office of Management and Budget-approved standardized data collection tool. Participants were syndromic surveillance staff from each of 31 state and local health departments participating in the National Syndromic Surveillance Program funded by the Centers for Disease Control and Prevention. Questions included jurisdictional experience, data sources and analysis systems used, syndromic system data processing characteristics, data quality verification procedures, and surveillance activities conducted with syndromic data. Practice-specific information such as types of systems and data sources used for syndromic surveillance, data quality monitoring, and uses of data for public health situational awareness (eg, investigating occurrences of or trends in diseases). The survey analysis revealed a wide range of experiences with syndromic surveillance. Participants reported the receipt of data daily or more frequently. Emergency department data were the primary data source; however, other data sources are being integrated into these systems. All health departments routinely monitored data quality. Syndromes of highest priority across the respondents for health events monitoring were influenza-like illness and drug-related syndromes. However, a wide variety of syndromes were reported as priorities across the health departments. Overall, syndromic surveillance was relevantly integrated into the public health surveillance infrastructure. The near real-time nature of the data and its flexibility to monitor different types of health-related issues make it especially useful for public health practitioners. Despite these advances, syndromic surveillance capacity, locally and nationally, must continue to evolve and progress should be monitored to ensure that syndromic surveillance systems and data are optimally able to meet jurisdictional needs.

Level of Household Satisfaction in Community Baesd Health Insurance Beneficiaries on Medical Laboratory Services and Its Associated Factors in Selected Health Centers

Background : Community-based health insurance (CBHI) scheme are emerging and growing tool for providing financial protection to deprived individuals against health-related events. And community based health insurance an emerging alternatives to increase primary health care accesses. There is an increasing interest in the role of CBHI scheme in improving equity and access to essential health care of the poor society’s particularly informal sector worker. On CBHI benefit package including both outpatient and in-patient services utilization at public facilities, enrolled household may not seek care in private health facilities unless a particular services or drug is unavailable at public health facilities. The scheme exclude treatment abroad and treatment with large cosmetics value such as artificial teeth and plastic surgery. Objective: To assess the level of household satisfaction in community based health insurance beneficiaries on medical laboratory services and associated factors in selected health center, Addis Ababa Ethiopia. Methods: Cross sectional study was conducted by using both quantitative collection methods data was collected by structured questionnaire. Quantitative data was entered analyzed using SPSS version Descriptive statistics, bivariate and a multivariable logistic regression analysis was performed. A 5-point Likert scale with 1 and 5 indicating the lowest and highest levels of satisfaction, respectively, was used and their weighted average was used to categorize the satisfaction level of the patients. Result: Among the 366 CHBI beneficiaries, 194(53%%) were satisfied, 111(30.3%%) were Neutral and 61(16.7%%) were dissatisfied with general Laboratory service provided ,There was no significant association between socio-demographic characteristics and level of satisfaction of patients (P- value > 0.05) In Likert Scale, the overall mean rate of satisfaction of patients with laboratory services selected health center was 3.5 out of the 5 points. The lowest mean rating of satisfaction were given availability of service provider explained about diagnostic test during sample collection and Cleanliness and comfort of the latrine of 2.79 and 2.96 respectively. Conclusion: The overall Household’s satisfaction in CBHI beneficiaries on medical laboratory service done in selected health centers in Addis Ababa was 53%. The level of satisfaction of the patients was no statistically significant association by age, sex, edu­cational level, marital status and religion. The availability of service provider explained about diagnostic tests during sample collection ,cleanness and comfort of the latrine and insufficient waiting area also unavailability of educating and entertaining materials was the main cause of low rating in the overall level of satisfaction in CBHL beneficiaries. Keywords : - community based health insurance, household satisfaction, laboratory service DOI: 10.7176/FSQM/98-04 Publication date: June 30 th 2020

OP0188 INTEGRATED SAFETY SUMMARY OF THE NOVEL, INTRA-ARTICULAR AGENT LORECIVIVINT (SM04690), A CLK/DYRK1A INHIBITOR THAT MODULATES THE WNT PATHWAY, IN SUBJECTS WITH KNEE OSTEOARTHRITIS

Background:Concerns over the safety of available osteoarthritis (OA) treatments have led to revision of treatment guidelines and highlight the need for new therapies. Lorecivivint (LOR; SM04690) is an intra-articular (IA), small-molecule CLK/DYRK1A inhibitor that modulates the Wnt pathway and is in development as a potential disease-modifying treatment for knee OA.1,2Objectives:To evaluate pooled early-phase LOR clinical data for safety, including bone health-related adverse events (AEs).Methods:Safety data were pooled from 3 randomized controlled trials (one Phase 1, two Phase 2) evaluating 4 doses (0.03 mg, 0.07 mg, 0.15 mg, 0.23 mg) of a single IA injection of LOR in subjects with moderately to severely symptomatic knee OA. Two trials (NCT02095548;NCT03122860) evaluated subjects for 24 weeks and one trial (NCT02536833) for 52 weeks. AEs, serious AEs (SAEs), and bone health AEs were categorized by Medical Dictionary for Regulatory Activities (MedDRA) classification. Incidences of AEs and SAEs were compared between the combined LOR-treated group (subjects who received any dose of LOR) and a control group (subjects not treated with LOR).Results:This analysis includes 848 LOR-treated and 360 control subjects. The incidence of AEs was similar in LOR-treated (350/848 [41.3%]) and control subjects (138/360 [38.3%]). Incidence of SAEs was 20/848 (2.4%) in LOR-treated and 4/360 (1.1%) in control subjects. The most commonly reported AE in LOR-treated subjects was arthralgia (treated 7.6%, control 7.2%) and was the only AE reported at >5% in either group (Fig. 1). Target-knee arthralgia was the most common joint-specific AE (treated 6.5%, control 5.3%) (Fig. 2). No AEs in other joints exceeded an incidence of 2% in either group. In all categories, individual AEs were reported at similar rates between groups and no SAEs were deemed related to LOR by investigators.Figure 1.Adverse event summary for events occurring in at least 1% of the treated population (N=1208).Figure 2.Joint-specific adverse event summary, subcategorized by affected joint, for events occurring in at least 1% of the treated population (N=1208).There were 16 bone health-related AEs in 9/848 (1.1%) LOR-treated and 3/360 (0.8%) control subjects. Of the bone health AEs, 2 were osteopenia/osteoporosis in 2 LOR-treated postmenopausal women and 14 were fractures in 10 subjects (7 LOR-treated, 3 control). All fractures (3 patellar [1 target knee, 2 non-target knee], 3 vertebral, 2 foot, 2 wrist, 2 rib, 1 fibula, 1 hand) were adjudicated and determined to be caused by trauma; all healed uneventfully within the expected time frame.Conclusion:In exposure to date of 848 subjects, IA LOR for the treatment of knee OA appeared to be safe and well tolerated. These data support the continued evaluation of LOR as a potential treatment for knee OA.

Guest Editorial.

This Special Issue of the Australian Dental Journal coincides with an unprecedented health event in the 21st century: the COVID-19 pandemic. Given the social and economic consequences of the disease, the vivid debate about the most effective public health measures to tackle the epidemic and the global spread of the epidemic,1 people worldwide are becoming familiar with words such as ‘epidemiology’, ‘epidemic curve’, ‘fatality rate’, ‘surveillance systems’ ‘prediction’, ‘modelling’, among other. However, what is epidemiology? Epidemiology has been conceptualised as ‘the study of the occurrence and distribution of health-related events, states, and processes in specified populations, including the study of the determinants influencing such processes, and the application of this knowledge to control relevant health problems’. Two central assumptions support this definition and, therefore, Epidemiology itself: (i) the diseases, health conditions, and their determinants are not randomly distributed in a population; (ii) the knowledge of these factors has practical implications for the control and prevention of diseases and health problems.2 This Special Issue of the Australian Dental Journal is about epidemiology, more precisely about oral epidemiology, the branch of epidemiology dedicated to oral diseases and disorders its socioeconomic, behavioural and health services related factors. It describes the state of oral health and use of dental services of the Australian adult population using information from the National Study of Adult Oral Health (NSAOH) 2017–18.3 The NSAOH 2017–18 was conducted by the Australian Research Centre for Population Oral Health (ARCPOH) at the University of Adelaide in partnership with the Australian Government Department of Health and State/Territory health departments and dental services with support from the National Health and Medical Research Council (NHMRC). This national study involved collection of interviews from over 15,000 adults across Australia, with clinical oral epidemiological examinations performed on over 5,000 people. NSAOH 2017–18 is only the third national oral examination survey of adults in Australia. It follows from the second National Survey of Adult Oral Health conducted in 2004–06,4 and the initial National Oral Health Survey of Australia 1987–88.5 The purpose of this Special Issue is to provide a descriptive ‘snapshot’ of oral health in the adult population of Australia and to describe their use of dental services. The findings provide up-to-date evidence that can contribute to the development of oral health policies and programs in Australia. Such evidence continues to be essential because oral diseases represent a considerable burden on the health of the public. This calls for information about the distribution of oral disease and provision of dental care among relevant subgroups of the Australian population. This report also includes some comparisons of results with the first two surveys, evaluating trends in oral disease and dental care that have occurred over the past 30 years. These trends provide insights into historical influences on dental care and likely trends in oral health status. The first set of papers deal with the methods involved in relation to sampling, data collection, weighting of the data and representativeness. Following these methods papers are a set of papers that describe oral health status for outcomes such as tooth loss, caries and periodontal disease. Other important oral conditions such as fluorosis and xerostomia are also presented. The final set of papers includes impacts of oral conditions, use of dental services and dental behaviours. Together the information in these papers reflects a valuable national resource that demonstrates the widespread nature of oral diseases in the Australian population, the impacts of these oral diseases, the groups within our society that suffer the greatest burden from oral diseases and the importance of access to dental services for Australians.

Risk management in suburban forest recreation areas: A retrospective analysis of illness cases

Participating in forest recreation activities sometimes involves risks that result in illnesses and/or injuries. One important risk factor is participants’ preexisting medical conditions, which may lead to illness incidents. Little has been studied about the relationship between participants’ illnesses and their preexisting medical conditions, and, from a risk management perspective, that is crucial information with which to identify vulnerable groups for preventing incidents. Finding answers can help the site managers of Xitou Nature Education Area (XNEA) in Taiwan (R.O.C.) in risk management planning. Therefore, we retrospectively analyzed emergency medical service records between July 2012 and June 2018 that included each patient’s age, sex, date, time, preexisting health conditions, and illness contracted. Of the 276 patients assessed, 56.2% were female. More than half (55.4%) had preexisting medical conditions. The most common symptom was dizziness (47.8%). Most health-related events occurred in the morning and during summer months. Elderly visitors (≥60 years) were the most vulnerable to illness. More men than women encountered syncope. Participants with high blood pressure had a higher risk of dizziness, respiratory problems, and syncope. Individuals with diabetes were vulnerable to weakness. Visitors with cardiac-related problems were likely to have chest pain or tightness in their chest. Preexisting medical conditions constitute an inherent risk in visitors, and this association with the occurrence of illness during forest recreation confirmed higher risks in specific patient groups. This epidemiological study describes the characteristics of illnesses and identifies the at-risk groups to facilitate future risk management planning for forest recreation in XNEA.

The 2017 Solar Eclipse: Implementing Enhanced Syndromic Surveillance on the Path of Totality in Kentucky.

The 2017 solar eclipse was associated with mass gatherings in many of the 14 states along the path of totality. The Kentucky Department for Public Health implemented an enhanced syndromic surveillance system to detect increases in emergency department (ED) visits and other health care needs near Hopkinsville, Kentucky, where the point of greatest eclipse occurred. EDs flagged visits of patients who participated in eclipse events from August 17-22. Data from 14 area emergency medical services and 26 first-aid stations were also monitored to detect health-related events occurring during the eclipse period. Forty-four potential eclipse event-related visits were identified, primarily injuries, gastrointestinal illness, and heat-related illness. First-aid stations and emergency medical services commonly attended to patients with pain and heat-related illness. Kentucky's experience during the eclipse demonstrated the value of patient visit flagging to describe the disease burden during a mass gathering and to investigate epidemiological links between cases. A close collaboration between public health authorities within and across jurisdictions, health information exchanges, hospitals, and other first-response care providers will optimize health surveillance activities before, during, and after mass gatherings.

Profile of people seeking health services during Pope Francis' visit to Mozambique, 2019.

Pope Francis visited Mozambique from September 4-6, 2019. During the visit, a real-time surveillance system for mass gathering events was implemented in all places where people gathered in Maputo City for early detection of possible outbreaks and other health-related events. The system was implemented at four sites were mass gathering events occurred over the three-day visit. Data were collected by administering a simple questionnaire on a tablet, which collected information about sociodemographics, syndromic diagnoses, and outcomes of the patients that sought medical care. Additionally, a descriptive epidemiological assessment was performed during the event. A total of 150 individuals were attended at the designated places during the event. Of these, 56.7% were female and 90.7% aged > 15 years. The majority of the patients (74.7%) sought care on the third day of the event, which was held at the Zimpeto National Stadium. The most common diagnoses were hypertension (20.7%), hypothermia (15.3%), and headache (11.3%). Almost all cases (95.0%) were discharged, (4.0%) cases were transferred and (1.0%) case resulted in death on the way to the health facility. The surveillance system strategy developed to detect real-time public health events during the Pope?s visit was successfully implemented. No outbreak was identified during the event.

Positive Epidemiology?

Positive Epidemiology?

A Study of Longitudinal Trajectories of Health and Job Demand on Retirement Age

In this paper, we characterized health trajectories over an 18-year period for a cohort of American workers. We used administrative data to track monthly, health-related events for six chronic diseases (asthma, arthritis, diabetes, depression, ischemic heart disease, and hypertension) including the diagnoses of new disease, hospitalizations, and outpatient visits. Using these data, we first used sequence and cluster analysis to characterize long-term trajectories of health and to group workers according to their patterns of work experience. We then modeled the relationship of these health trajectories to retirement age, accounting for baseline underlying health, as well as a number of demographic and job-related characteristics. Finally, we consider the role of physical and psychosocial job demand in retirement age. Our analysis produces a number of findings that should be of interest to those studying retirement policy. In our data, workers can be categorized into a small number of distinct work trajectories. While the majority of workers in this sample remain relatively healthy for much of the observation window, others exhibit patterns of health-related events that are often marked by hypertension and/or arthritis. We find that clusters characterized with health events related to hypertension and arthritis are likely to retire later, not earlier. We offer a possible interpretation that these numerous health-related events are signaling the proper management of these chronic diseases, allowing workers to extend their working life. Moreover, we find an association with job demands and retirement, even after controlling for health. Specifically, we find that increases in exposure to heat are associated with lower retirement age, as is less decision-making autonomy. The limitations of this paper include the lack of a representative sample, a relatively small sample size, and the strong incentives of retirement pensions in this cohort that may overwhelm other factors related to retirement decisions.

Comprehensive Risk Assessment of Health-Related Hazardous Events in the Drinking Water Supply System from Source to Tap in Gaza Strip, Palestine.

Background The traditional approach in the management of the quality drinking water, and relying on end-product testing, has proven ineffective in protecting public health. Therefore, the transition to a systematic approach in drinking water supply systems management from the source to the consumer tap was taken as a water safety plan (WSP). Objective The study aims to investigate the health-related hazardous events in order to decide on the best risk-reduction strategies in the supply of drinking water in the Gaza strip. Methods A semiquantitative matrix method for risk assessment was applied. Also, chlorine residual, electrical conductivity, and nitrate concentration further tested in 109 water wells, 109 small-scale water desalination plants, 197 tanker trucks, and 384 households distributed over five governorates of the Gaza strip. Results The mean of the measured chlorine residual values was less than the recommended national and international limits (0.2–1 mg/liter). The mean of electrical conductivity at catchment points and household municipal water taps was 2165.1 μS·cm−1 and 2000 μS·cm−1, respectively. Furthermore, zero percent of water samples met the recommended criteria, indicating that the groundwater in the Gaza strip is nonpotable. Only 12.8% and 8.8% of water samples met the permissible levels at catchment areas and municipal water at household, respectively, indicating sever health impacts on the public. Moreover, the most hazardous events were related to high levels of groundwater salinity, the low level of disinfection, the effect of electricity outages on the efficiency of the desalination process, and leakage of water from the tanker truck tank reservoirs. Therefore, urgent interventions are required to improve the quality of water and to mitigate the possible health effects. Conclusion The prioritization of hazardous events that are proportional to the degree of their attributed risk could help guide in making the right risk-reduction decisions. Urgent interventions are required to improve the quality of water and to mitigate the possible health effects.

Advanced Interoperability Techniques: Structure Mapping Service in CrowdHEALTH Project.

Due to healthcare information systems interoperability issues, health-related events may be missed. Numerous techniques based on medical standards and technologies have been recommended to address this challenge. Nevertheless, these techniques do not follow a holistic approach. The purpose of the paper is to present the structure mapping service which is developed in the context of the initial design of the interoperability solution of the CrowdHEALTH project. In the CrowdHEALTH project, subcomponents responsible for providing the appropriate interoperability solution have been created with first the rule engine for the implementation of the business logic. Another subcomponent responsible for creating and managing the knowledge related to the link that exists between information structures, or mappings between them, is the Structure Mapping Service. The envisioned approach for structure mapping is based on ontology alignment. Besides, the Terminology Service is responsible for providing a set of operations on medical terminologies used for the coding of medical knowledge, which fills the information structures. Within the development of the Structure Mapping component, the Ontology alignment process will be automated. Two phases exist when using the structure mapping service: the training phase and the run-time phase. In the training phase ontologies are created and are aligned, and data maps between the use case (source) data sets and the HHR Manager classes (target) are formed. Afterward, these data maps can be stored in the knowledge base. In the runtime phase, queries can be made to the structure mapping component by the data converter. The structure mapping controller can then access the Knowledge Base to retrieve the appropriate mapping and transformations and provide these as a response to the query. The initial design of the advanced interoperability techniques is described with emphasis put to Structural Mapping service which can be easily deployed and seamlessly integrated into healthcare settings. This design will be assessed and further enriched during the project life circle.

COVID-19 Pandemic Impact in India

In the Past, the World has faced severe diseases like cholera and Plague. Many Scholars have researched them and found out when and how these diseases have been spread. Cause of most diseases found and vaccines has made. Corona has been declared a Global Pandemic and has drastically affected the socio, economic and geographical condition of almost all the countries of the world. The occurrence in a community or region of cases of illness, specific health-related behavior, or other health-related events clearly in excess of normal expectancy known as Epidemic. – WHO Corona virus disease (COVID-19) is noted in 2019. Common signs of infection include respiratory symptoms, fever and cough, shortness of breath and breathing difficulties. In more severe cases, the infection can cause pneumonia, severe acute respiratory syndrome, Lungs failure and even death.COVID-19 Virus Spreading Speedily in India from March 2020. Government of India decided 21 days completely lockdown in India by 24 March 2020. Due to the Lockdown announced by the Indian government all type works, Jobs and business suspended for unspecified times. Most of the business is Sinking due to Lockdown or working very slow. Period of current crisis unknowable. Amidst the COVID-19 pandemic Hospital has ventilator shortage. The Entire world is under one of the most pandemic situation ever caused on earth. Millions of people have become the victim of this deadly disease. We don’t even know how long it would still go.In my view if there is Negative, there is Positive too. See some positivity in each day, even if days you have to look is little harder. There are so many changes happening around the world.

Psychosocial Aspects of Covid-19, the Indian Way

The psychosocial impact of the Covid-19 pandemic has been related to not only the viral epidemic but also by the sudden and extended lockdown. The prominent psychosocial issues are related to the stigma, changed lifestyle, impact on persons with mental health problems and mental illnesses including alcoholism and substance use, chronic medical illnesses, and this being one or more major life event. Social issues due to this stigma manifest as avoidance, discrimination, isolation, and seclusion of persons suspected to be anyway related to Covid-19. There are also self-stigma and fear of spreading it to the family members. However, the stigma associated with Covid-19 reduced stigma toward mental health and focused on the need of mental health support. This pandemic and its consequent lockdown to contain the spread of the viral infection will form a new health-related life event. During this period, there is a growing concern about the rise in domestic abuse and violence being reported by the media. Lockdown brought about reports in media about emotional disturbances and maladjustments within families including families of persons with mental illness. Finally, there has been a revival of cultural defenses in the form of traditional practices; people are reverting back to a folded hand “namaste” instead of a handshake, washing hands frequently, and use of a mask.

Prevalence, Incidence, and Risk Factors for Tinnitus.

How many people are affected by tinnitus? Is the risk of developing tinnitus on the rise or has it been declining over time? What modifiable lifestyle factors could help to prevent tinnitus? These population-based questions can be addressed through epidemiological research. Epidemiology refers to the underlying and basic science of public health. It describes the study of the distribution and determinants of health-related states or events in specified populations and the application of this study to the control of health problems. There are two key concepts in epidemiology: (1) measures of frequency and (2) measures of effect. In this chapter, we introduce the two main measures of frequency, prevalence and incidence. We also introduce the notion of risk factors, critical for understanding measures of effect concerning the risk of developing a health condition. In both sections, we provide illustrative examples from the published literature on tinnitus. We end by offering a critical evaluation of the current status of epidemiological research on tinnitus and point to some promising future directions.

Maternal Death Surveillance System Evaluation at Addis Ababa City Administration, Ethiopia, 2018

Introduction: Public health surveillance is an ongoing, systematic collection, analysis, interpretation, and dissemination of data regarding a health-related event for use in public health. Maternal Death Surveillance and Response (MDSR) is form of continuous surveillance linking the health information system to quality improvement processes from local to national levels. Ethiopia has been implementing Maternal Death Surveillance and Response for the last four years. The aim of evaluating Maternal Death Surveillance and Response system at Addis Ababa City Administration was to evaluate the performance and identify gaps of existing system in city administration 2018. Methods: A descriptive cross-sectional study design was used to evaluate Maternal Death Surveillance and Response system at Addis Ababa City Administration, which was conducted from March 12-23/2018. Purposive sampling technique was used to select 13 study units. Primary data was collected using structured questionnaire and crosschecked with available documents. Data was analyzed using Microsoft Office Excel, 2016. Result: Only 67% of study units had appropriate denominator and the denominator at city level was 1168157 (34.6% of total population). All study units had maternal death review committee and the action threshold used by all study units was one maternal death. A total 52 maternal death notifications received by the region from Sept/2016 to Aug/2017, giving case detection rate of 13% of national plan for the city. All notifications were true maternal deaths. Cause of death identified for 50 (96.15%) of deaths and only findings from 7 (14%) deaths used for action. No separate budget was allocated for Maternal Death Surveillance and Response system at all levels. MDSR system implementation at private health facilities was almost neglected and overall average attribute measurement for the system was 63%. Conclusion: Maternal Death Surveillance and Response system establishment objectives will not be achieved by current level of implementation and detection. Data utilization and attributes value was very low. Lack of separate budget affects the system implementation.

Evaluation of Event Based Surveillance System of Crimean Congo Haemorrhagic Fever in Balochistan Pakistan, 2017

Background: Crimean Congo Haemorrhagic Fever (CCHF) is an acute viral zoonotic disease that is endemic in Pakistan. Poverty, limited awareness and lack of biosafety practices make it a potential occupational health risk. A poor surveillance system makes it more difficult to monitor the disease burden. Purpose: An evaluation was carried out to identify the strengths and weaknesses of the event-based CCHF surveillance system in Balochistan, Pakistan, and to propose recommendations for improvement. Methods: A descriptive evaluation study was conducted at an isolation ward of a public hospital from November 2017 to February 2018 in Balochistan Province. Event-based CCHF surveillance system was evaluated by using updated CDC guidelines for Evaluating Public Health Surveillance Systems. Data were collected through review of records and interaction with stakeholders. Using a semi-structured questionnaire, surveillance system attributes were assessed according to the guidelines in the study tool. Findings: The system was simple, but had no standardised case definition. It was found to be flexible as new health-related events could be easily incorporated. Data quality was moderate; 80% (75/94) of the reports were completely filled. The system had good timeliness but lacked involvement of the private sector. Acceptability was good with involvement of different government stakeholders. Sensitivity was poor while positive predictive value was 27.5%. Conclusion: Event based surveillance for CCHF can be improved by involvement of private practitioners and laboratories in the surveillance system to improve representativeness. The timeliness could be improved by adopting an online reporting mechanism. Feedback, support and supervision should be ensured for data quality assurance. Periodic refresher trainings of the staff could be organized.

Spatial Lifecourse Epidemiology Reporting Standards (ISLE-ReSt) statement.

Spatial lifecourse epidemiology is an interdisciplinary field that utilizes advanced spatial, location-based, and artificial intelligence technologies to investigate the long-term effects of environmental, behavioural, psychosocial, and biological factors on health-related states and events and the underlying mechanisms. With the growing number of studies reporting findings from this field and the critical need for public health and policy decisions to be based on the strongest science possible, transparency and clarity in reporting in spatial lifecourse epidemiologic studies is essential. A task force supported by the International Initiative on Spatial Lifecourse Epidemiology (ISLE) identified a need for guidance in this area and developed a Spatial Lifecourse Epidemiology Reporting Standards (ISLE-ReSt) Statement. The aim is to provide a checklist of recommendations to improve and make more consistent reporting of spatial lifecourse epidemiologic studies. The STrengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement for cohort studies was identified as an appropriate starting point to provide initial items to consider for inclusion. Reporting standards for spatial data and methods were then integrated to form a single comprehensive checklist of reporting recommendations. The strength of our approach has been our international and multidisciplinary team of content experts and contributors who represent a wide range of relevant scientific conventions, and our adherence to international norms for the development of reporting guidelines. As spatial, location-based, and artificial intelligence technologies used in spatial lifecourse epidemiology continue to evolve at a rapid pace, it will be necessary to revisit and adapt the ISLE-ReSt at least every 2-3 years from its release.

Long-term effectiveness and safety of varenicline and nicotine replacement therapy in people with neurodevelopmental disorders: A prospective cohort study

This study aimed to determine the effectiveness and safety of varenicline versus NRT for smoking cessation in people with neurodevelopmental disorders, compared to those without, at up to four years after exposure. We analysed electronic medical records from the Clinical Practice Research Datalink using three different statistical approaches: multivariable logistic regression, propensity score matching (PSM), and instrumental variable analysis. Exposure was prescription of varenicline versus NRT and the primary outcome was smoking cessation at 2-years. We included 235,314 people aged 18 and above with eligible smoking cessation prescriptions in the effectiveness analysis. Smokers with neurodevelopmental disorders were 48% less likely (95% confidence interval: 42%, 54%) to be prescribed varenicline than NRT, compared to smokers without neurodevelopmental disorders. At 2-year follow-up, smokers with neurodevelopmental disorders prescribed varenicline were 38% more likely to quit smoking (95% confidence interval: 6%, 78%). Similar results were obtained using PSM and instrumental variable analyses. There was little evidence showing that varenicline increased the likelihood of mental health related adverse events in people with neurodevelopmental disorders. Varenicline is less likely to be prescribed to people with neurodevelopmental disorders despite results suggesting it is more effective than NRT and little evidence of increased likelihood of mental health related adverse events.

A cross-sectional study on health related behaviors among swimming pool users and sanitary conditions of swimming pools in Hubballi city

Background: With evolving and advancing civilization, man-made water recreational environments such as swimming pools, not only offer health promotions and social benefits but are also accompanied with health risks. It is necessary to properly manage and consistently monitor swimming pool to make sure about water treatment methods and health, to protect health of the users. This study aimed to assess the health related behaviours in swimming pool users and to study sanitary condition of swimming pool.Methods: A cross-sectional study done in Hubballi city among swimming pool users. A semi-structured pre-tested self-administered questionnaire applied to 200 participants of 3 swimming pools. Data collected regarding socio-demographic details, swimming pool regulations, health related events and health benefits and sanitary conditions of swimming pool.Results: Among 200 participants, 65% were males and 35% were females. 78.5% of the participants had knowledge about swimming pool regulation. 68% had unhealthy habits in swimming pool, among these 62% had at least one reported symptom. 73% of males had unhealthy habits and 57% had at least one reported symptom (p<0.05 significant). As the experience in swimming increases, unhealthy habits decreases (p<0.05 significant) and symptoms will be decreased (p<0.05 significant).Conclusions: In our study majority of the participants had unhealthy habits and knowledge about swimming pool regulations. All swimming pools were chlorinated and pH was maintained within WHO recommended guidelines.

In-home monitoring evaluation by home-dwelling older adults, caregivers and healthcare providers

Abstract Background In Europe, population ageing is increasing the healthcare needs and costs. Both frailty and chronic diseases affecting older people reduce their ability to live independently. However, most older people prefer to age in their own homes. New development of in-home monitoring can play a role in staying independent, active and healthy. Our objective was to evaluate a new in-home monitoring system among home-dwelling older adults (OA), their family caregivers (FC), and their healthcare providers (HCP) for the support of home care. Methods The system continuously monitored OA’s daily activities (e.g., mobility, sleep habits, fridge visits, door events) at home by ambient sensor system (DomoCare®) and health-related events by wearable sensors (Fitbit®, ECG). In case of deviations in daily activities (e.g., changes in mobility), alerts were transmitted to HCP via email. Using specific questionnaires, the opinion of 13 OA, 13 FC, and 20 HCP were collected at the end of 12-month of follow-up focusing on their user experience and the impact of in-home monitoring on home care services. Results These preliminary results underlined that the majority of OA, FC, and HCP consider that in-home sensors can help staying at home, improving home care, reducing family stress, and preventing domestic accidents. The opinion tended to be more favourable toward ambient sensors (80%) than toward Fitbit® (67%) and ECG (64%). On average, OA (80%) and FC (73%) tended to be more enthusiast than HCP (63%). Some barriers reported by HCP were a fear of weakening of the relationship with OA and an excessive surveillance. Conclusions Overall, the opinion of OA, FC and HCP were positive related to in-home sensors, with HCP being more mixed about their use in clinical practice. Key messages In-home monitoring technologies seem to be generally well accepted. In-home monitoring technologies could be help facilitating home care of older people.