Linkage Studies Research Articles

Sickness absence trajectories among young and early midlife employees with psychological distress: the contributions of social and health-related factors in a longitudinal register linkage study.

Psychological distress has been associated with sickness absence (SA), but less is known about whether there are distinct patterns in the development of SA among people with psychological distress. We examined trajectories of short- and long-term SA among employees with psychological distress and how social and health-related factors are associated with them. We used the employer's register data on all-cause short- (≤ 10 working days) and long-term (> 10 working days) SA with a two-year follow-up. We prospectively linked the Helsinki Health Study survey data on 19-39-year-old employees of the City of Helsinki, Finland, in 2017, to the SA data. We included 1060 participants (81% women) who reported experiencing psychological distress, measured by the emotional wellbeing scale of RAND-36. Survey responses of age; gender; education; marital status; social support, procedural and interactional organisational justice, and bullying at work; physical activity; diet; tobacco and alcohol use; prior SA; and the level of psychological distress were included as exposures. Group-based trajectory modelling and multinomial logistic regression were used for the analyses. We identified four short-term SA trajectories: 'low' (n = 379, 36% of participants), 'descending' (n = 212, 20%), 'intermediate' (n = 312, 29%), and 'high' (n = 157, 15%); and two long-term SA trajectories: 'low' (n = 973, 92%) and 'high' (n = 87, 8%). A higher education, fewer prior SA, and lower levels of psychological distress were associated with the 'low' short- and long-term SA trajectories. SA trajectories differ among employees with psychological distress. Early intervention and support are needed among employees with mental health symptoms to prevent future SA.

Identifying the unknown: Application of molecular epidemiology tools to identify clustering and HIV transmission routes in Poland.

Understanding the dynamics of HIV-1 transmission is essential for developing effective screening and intervention strategies. Viral genetic sequences provide valuable information that can be used to infer the history and patterns of viral transmission. Our study explores the structure and dynamics of HIV transmissions in Poland from 1999 to 2022 to elucidate key patterns related with national epidemics. To understand the temporal dynamics of transmission routes we examined HIV pol sequence data from 5705 Polish PWH. The HIV-TRAnsmission Cluster Engine (HIV-TRACE) was utilized to identify potential links between different risk groups and putative links to individuals with unreported transmission risk. Our analyses generated 503 clusters, containing 3942 individuals, and identified 13,917 putative links. Approximately 69.1 % of the sequences formed clusters. In the dataset 32.2 % of individuals were reported MSM transmission route, 7.9 % by heterosexual, and 5.6 % by PWID transmissions. The transmission route was unknown for 54.2 % of patients. Putative transmissions from MSM to all other groups revealed that 45.1 % of links lead to people with unregistered transmission mode. For heterosexual patients, 40.2 % of connections were directed to patients lacking information on infection routes and 30.5 % to MSM individuals. Our analysis unveiled that 45.1 % of cases with unreported transmission routes may be identified as MSM, while 3.5 % might be potential non-disclosed MSM. Genetic linkages can provide valuable insights into the transmission dynamics among individuals, even in cases where transmission risk information is missing or unreported. The observed association between MSM and unreported cases highlights the potential of molecular epidemiology to complete missing patient data.

A linkage study investigating sexualized self-presentation on mobile dating apps and user traits

Mobile Dating Applications (MDAs) are integral to young adults’ lives, serving as a platform for romantic and sexual self-presentation during the search for potential partners. Despite its potential link to adverse outcomes including body shame, the prevalence of sexualized self-presentation remains understudied. This pre-registered linkage study addresses this gap by documenting sexualized self-presentation while considering individual differences related to gender, sexual orientation, and body image. Young adults donated MDA (Tinder, Bumble) profile screenshots (nbiographies = 443, npictures = 1277; Mage = 23.15, SD = 2.94; 72.20 % women). Of those 443 participants, 237 additionally completed a body image linkage survey (Mage = 23.36, SD = 2.90; 71.30 % women). Sexualized self-presentation appeared in 4.30 % of biographies and 56.80 % of profile pictures, mainly through sexualized facial expressions. Women, non-heterosexual users, and those holding a more negative body image engaged more in sexualized self-presentation. Platform type and positive body image indicators did not relate to engagement in sexualized self-presentation. Future research is recommended to explore whether the extensive presence of sexualized self-presentations on MDAs impacts users’ personal and relational well-being.

All-cause and cause-specific mortality inequalities between people with and without disability: a nationwide data linkage study in Australia

Without high-quality statistics on mortality inequalities, designing policies to improve the health of people with disability is challenging. We aim to quantify mortality inequalities experienced by people with disability in Australia. In this nationwide, data linkage study we used Census mortality linked data (2011-20) to construct a cohort of Australians aged 0-74 years. Disability was measured as requiring assistance or supervision in core daily activities. We estimated age-standardised and age-specific mortality rates, and absolute and relative mortality inequalities between people with and without disability. 15 216 195 people were included in the study, comprising 7 763 047 females and 7 453 148 males. Of the participants, 258 109 (3·5%) males and 228 658 (2·9%) females reported disability, with 462 990 deaths occurring over 138 540 359 person-years of follow-up. Per 100 000 person-years, there were 2067 (95% CI 2043-2091) more deaths in males and 1697 (1677-1718) more deaths in females with disability (3·69 and 4·64 times higher, respectively) than those without disability. Cancer and cardiovascular disease had the highest absolute inequalities, with rate differences of 462 (95% CI 449-476) for males and 368 (356-379) for females for cancer, and 471 (95% CI 459-483) for males and 333 (324-342) for females for cardiovascular disease. Less common causes among people without disability-neurological conditions, chronic lung diseases, endocrine diseases, and digestive diseases-are relatively common among people with disability, translating to high relative mortality inequalities. The largest relative inequalities were from neurological conditions, with rate ratios of 9·66 (95% CI 9·31-10·02) for males and 11·61 (11·13-12·10) for females. Relative and absolute inequalities were also substantial for unintentional injury and for suicide mortality. Age-specific mortality was consistently higher in people with disability. The leading contributors to absolute inequalities shifted from neurological conditions in younger ages to cancer, cardiovascular diseases, and chronic lung diseases in older ages. People with disability experience large mortality inequalities. Identifying intervention-amenable factors contributing to these inequalities should be a priority. Targeted interventions and policy reforms to create a more inclusive social and health-care environment for people with disability might be necessary. The University of Melbourne.

Effectiveness of Asthma Preventer Dispensing for Preventing Childhood Asthma Readmissions: A Multisite Cohort Linkage Study.

Effectiveness of Asthma Preventer Dispensing for Preventing Childhood Asthma Readmissions: A Multisite Cohort Linkage Study.

Unplanned hospitalisations among subsidised nursing home residents in Singapore: Insights from a data linkage study.

Hospitalisations can pose hazards and may not be an appropriate care setting for frail nursing home (NH) residents. Few studies have quantified the extent of NH resident hospitalisations in Singapore, hence we aimed to address this knowledge gap by studying characteristics of unplanned hospitalisations over a 1-year period. This was a retrospective cohort study of 9922 subsidised residents across 59 NHs in Singapore, with analysis using administrative healthcare data. Key measures included inpatient admission and emergency department visit rates, final discharge diagnoses and estimated costs. We examined correlates of inpatient admissions with a multivariable zero-inflated negative binomial regression model incorporating demogra-phics, institutional characteristics and Charlson Comorbidity Index. There were 6620 inpatient admissions in 2015, equivalent to 2.23 admissions per 1000 resident days, and the majority were repeat admissions (4504 admissions or 68.0%). Male sex (incidence rate ratio [IRR] 1.23), approaching end-of-life (IRR 2.14), hospitalisations in the past year (IRR 2.73) and recent NH admission within the last 6 months (IRR 1.31-1.99) were significantly associated with inpatient admission rate. Top 5 discharge diagnoses were lower respiratory tract infections (27.3%), urinary tract infection (9.3%), sepsis (3.1%), cellulitis (1.9%) and gastroenteritis (1.1%). We estimated the total system cost of admissions of subsidised residents to be SGD40.2 million (USD29.1 million) in 2015. We anticipate that unplanned hospitali-sation rate will increase over time, especially with an increasing number of residents who will be cared for in NHs. Our findings provide a baseline to inform stakeholders and develop strategies to address this growing problem.

Caesarean section and risk of infection in offspring: systematic review and meta-analysis of observational studies

ObjectiveTo compare the risk of hospital admissions with infections and infections not in hospital in children born by caesarean section with children born by vaginal birth.Data sourcesMedline, Embase, and PubMed...

Maternal Cannabis Use Disorder and Neonatal Health Outcomes: A Data Linkage Study.

We tested for the potential associations between maternal antenatal cannabis use disorders (CUD) and neonatal health outcomes using large linked administrative data. Population-based retrospective cohort study. The study was conducted in New South Wales, Australia. A total of 215 879 singleton live births. Generalised linear models (GLMs) fitted using log-binomial regression to estimate risk ratios (RRs) with the corresponding 95% confidence intervals (95% CI). Additionally, we conducted a propensity score matching (PSM) analysis. The outcomes include preterm births (PTB), low birth weight (LBW), small for gestational age (SGA), 5-min lower Apgar scores and admission to the neonatal intensive care unit (NICU). In unmatched analyses, antenatal CUD was associated with increased risks for all adverse neonatal outcomes (adjusted risk ratio [RR] ranging from 1.47 [95% CI: 1.01, 2.14] for 5-min lower APGAR scores to 2.58 [95% CI 2.28, 2.91] for PTB). In PSM analyses, we observed slightly attenuated risks of PTB (RR = 1.98 [1.70, 2.31]), LBW (RR = 2.46 [2.13, 2.84]), SGA (RR = 1.84 [1.44, 2.35]) and admission to NICU (RR = 1.91 [1.49, 2.45]) after matching by covariates. However, we found no significant association between antenatal CUD and 5-min low APGAR scores (RR = 1.47 [0.94, 2.30]). We found that maternal antenatal exposure to CUD is associated with a range of adverse neonatal outcomes. This study highlights that targeted interventions focusing on antenatal counselling are recommended to mitigate risks associated with maternal cannabis use.

Low-acuity emergency department presentation characteristics and their association with Medicare-subsidised general practitioner services across New South Wales: A data linkage study.

Identify clinical and demographic characteristics of low-acuity presentations (LAPs) to the ED and analyse correlations between population rates of LAPs to ED and rates of Medicare-subsidised general practitioner (GP) services across statistical areas. Retrospective data linkage study using state-wide ED data and publicly available data on GP services per population by statistical area. We performed multilevel logistic regression to determine predictors of LAP at an individual level after adjusting for remoteness categories and performed correlations between rates of LAP and GP services per population across statistical areas in New South Wales, Australia. The primary outcome was the rate of LAPs to ED, LAPs being defined as patients who self-presented to ED, assigned an Australasian Triage Score of 4 or 5 and subsequently discharged from ED. There were 2.9 million ED presentations in 2021, of which 39.9% presentations were classified as LAP. LAPs were associated with younger age, routine care, eyes, ear, nose and throat and musculoskeletal presentations. The rate of LAPs was higher in non-metropolitan areas. Additionally, 85% of LAPs were seen and discharged from ED within 4 h. There was an inverse correlation between the rate of Medicare-subsidised GP services and the rate of total ED or LAPs in non-metropolitan areas (ρ = -0.47, ρ = -056 and P = 0.012, P = 0.001, respectively). In metropolitan areas, correlations were either positive for all ED presentations (ρ = +0.41, P = 0.007) or not significant for LAPs (ρ = +0.18, P = 0.57). A relationship between LAPs to ED and Medicare-subsidised GP episodes of care exists for non-metropolitan but not metropolitan areas.

Profiling CARD14 gene expression in Indian Psoriasis patients

Several Genome Wide linkage Studies on psoriasis performed to gain insight of genetic architecture of the disease. Caspase Recruitment Domain-containing family 14 (CARD14) also known as CARMA2 or BIMP2; cytogenic location: 17q25.3, is a scaffold protein that primarily controls the skin epidermis’s nuclear factor kB (NF-kB) signaling pathway activity in skin epidermis, a master gene for inflammation, has been shown to be linked with rare, heritable form of psoriasis. CARD14 is predominantly expressed in keratinocytes and epithelial cells, but also in unidentified dermal cells. For better understanding of molecular processes involved in CARD14 underlying Indian psoriatic patients, we analyzed gene expression of 42 moderates to severe cases of plaque psoriasis and same number of controls using qPCR and its validation through Immunohistochemistry (IHC). This study identifies that the expression of CARD14 in dermal endothelial cells among patients with psoriasis and explores the potential functional consequences associated with an overactive CARD14 gene. Furthermore, the expression data from the western population was consistent with the results of the qPCR validation of the candidate gene. There is a significant correlation between Indian psoriasis vulgaris patients and CARD14 up-regulation, as evidenced by a roughly two-fold shift in lesional tissue expression. This provides insights into the pathways and genes linked to the pathogenesis of psoriasis.

Associations Between Cancer-Related Fatigue and Healthcare Use During Cancer Follow-Up Care: A Survey-Administrative Health Data Linkage Study.

Little is known about the impacts of fatigue after cancer treatment, including whether cancer-related fatigue impacts people's use of healthcare. This study sought to examine how cancer-related fatigue impacts healthcare use after completing cancer treatment. A population-based survey was administered in Nova Scotia, Canada, to examine survivors' experiences and needs after completing cancer treatment. Respondents included survivors of breast, melanoma, colorectal, prostate, hematologic, and young adult cancers who were 1-3 years post-treatment. Survey responses were linked to cancer registry, physicians' claims, hospitalization, and ambulatory care data. Data were analyzed descriptively and using regression models. The final study cohort included 823 respondents. Younger respondents reported higher levels of cancer-related fatigue compared to older respondents. More females than males reported cancer-related fatigue. Upon adjusted analyses, those with cancer-related fatigue had lower odds of being discharged to primary care for their cancer-related follow-up (odds ratio = 0.71, p = 0.029). Moreover, those with cancer-related fatigue had 19% higher primary care use (incidence rate ratio = 1.19, p < 0.0001) and 37% higher oncology use (incidence rate ratio = 1.37, p < 0.016) during the follow-up period compared to those without cancer-related fatigue. Providers (oncology and primary care) may require additional support to identify clinically relevant fatigue and refer patients to appropriate resources and services.

Are there differences in low-acuity emergency department visits between culturally and linguistically diverse migrants and people with English-speaking background: a population-based linkage study of adults over 45

BackgroundGrowing numbers of avoidable low-acuity visits to emergency departments (ED) are a major health policy concern globally and are thought to contribute to ED crowding. This study explores the differences...

Participation in the National Bowel Cancer Screening Program by people with severe mental illness, Australia, 2006-2019: a national data linkage study.

To compare rates of participation in the National Bowel Cancer Screening Program (NBCSP) and follow-up for people with severe mental illness with those for people without severe mental illness or not prescribed antidepressants. Retrospective cohort study; analysis of de-identified linked NBCSP, Pharmaceutical Benefits Scheme (PBS), and Medicare Benefits Schedule (MBS) data. Australia, 2006-2019. People aged 50-74 years (NBCSP-eligible) with severe mental illness, defined as those dispensed two or more prescriptions for second generation antipsychotics or for lithium (PBS data), and a random sample of people aged 50-74 years eligible for Medicare-subsidised services but never prescribed psychotropic medications (antipsychotics, lithium, antidepressants). NBCSP participation (returned faecal occult blood test sample), valid test result, positive test result, and follow-up colonoscopy rates. A total of 119 475 people with severe mental illness and 1 090 574 control group people were included in our analyses. The proportion of women was larger in the severe mental illness group (51.3%) than the control group (48.7%), as were the proportions who lived in inner regional areas (23.5% v 19.1%) or in areas in the lowest socio-economic quintile (21.8% v 14.7%). The NBCSP participation rate was lower among people with severe mental illness (adjusted incidence rate ratio [IRR], 0.70; 95% confidence interval [CI], 0.69-0.84). The proportion of valid test results was smaller for people with severe mental illness (95.9% v 98.7%; adjusted IRR, 0.97; 95% CI, 0.96-0.99), and the positive test result proportion larger (12.3% v 6.6%; adjusted IRR, 2.01; 95%CI, 1.94-2.09). The proportion of positive test results followed by colonoscopy was smaller for people with severe mental illness (71.7% v 82.6%; adjusted IRR, 0.88; 95% CI, 0.85-0.92). People with severe mental illness were less likely to participate in the NBCSP or to undergo colonoscopy after a positive test result than other Australians. These differences may contribute to higher colorectal cancer mortality among people with severe mental illness. The contributions of differences in cancer stage at diagnosis and subsequent treatment to higher colorectal cancer mortality require further study.

Clinical outcomes following acute sore throat assessment at community pharmacy versus general practice: a retrospective, longitudinal, data linkage study.

To date, no research has compared longer-term outcomes (antibiotic provision; re-consultations; hospital admissions for quinsy; cost-effectiveness) following presentation with acute sore throat at general practice (GP) versus newer, pharmacy-led services. A retrospective, longitudinal cohort study of sore throat consultations between 1 November 2018 and 28 February 2020 either with the Wales pharmacy-led sore throat test and treat (STTT) service or with a healthcare professional at GP. Individual-level pharmacy consultation data from the national Choose Pharmacy IT application were securely uploaded to the Secure Anonymised Information Linkage Databank and linked to routinely collected, anonymized, population-scale, individual-level, anonymized health and administrative data. Of 72 736 index consultations, 6495 (8.9%) were with STTT and 66 241 (91.1%) with GP. Antibiotic provision at the index consultation was 1382 (21%) with STTT and 25 506 (39%) with GP [adjusted odds ratio (AOR), 0.30; 95% CI, 0.27 to 0.32]. Antibiotic provision within 28 days of index occurred in 1820 (28%) STTT and 26 369 (40%) GP consultations (AOR, 0.44; 95% CI, 0.41 to 0.47). GP re-consultation rate within 28 days of index date was 21% (n = 1389) with STTT compared with 7.4% (n = 4916) with GP (AOR, 3.8; 95% CI, 3.5 to 4.1). Coding limitations may lead to overestimates of GP re-consultations rates in the STTT group. Hospital admissions for quinsy were rare in both STTT (n = 20, 0.31%) and GP (n = 274, 0.41%) (AOR, 0.68; 95% CI, 0.43 to 1.1). STTT was less costly than consultation with GP. The pharmacy-led STTT service is safe, cost-effective, and contributes to antimicrobial stewardship.

EPID-07. MAJOR CONGENITAL ANOMALIES AND RISK OF CHILDHOOD BRAIN TUMORS IN 9 STATES

Abstract Children with congenital anomalies have a higher risk of developing a childhood brain tumor (CBT), but it remains unclear if associations vary by cancer histology, which could inform our understanding of these associations. Thus, we characterized co-occurrences of major congenital anomalies with six CBTs. We leveraged a population-based registry linkage study of live births, congenital anomalies, and cancer from nine states. Dates of birth and last follow-up varied by state, ranging between January 1, 1990 to December 31, 2018, for a total of 22,599,099 live births. CBT classification was based on the International Classification of Childhood Cancer for children diagnosed up to age 18 years. Major congenital anomalies were classified based on the National Birth Defects Prevention Network Surveillance Guidelines. Children with any genetic anomalies were excluded. We used Cox regression to evaluate associations between major congenital anomalies and astrocytoma, medulloblastoma, ependymoma, atypical teratoid/rhabdoid tumor (ATRT), primitive neuroectodermal tumors (PNET), and mixed and unspecified gliomas (“mixed gliomas”), adjusting for sex, state, maternal education, maternal race/ethnicity, and maternal age. Sensitivity analyses were conducted stratifying by number of major anomalies (0, 1, 2+) and age at cancer diagnosis (&amp;lt;1, 1-4, 5-9, 10+ years). There were 5,685 diagnosed with any CBT. Having any major congenital anomaly was significantly associated with astrocytoma, ATRT, medulloblastoma, mixed glioma, and PNET (aHR range: 1.79-5.78) but not ependymoma. When stratified by number of major anomalies, effect estimates were similar. Due to small numbers when stratified by age at cancer diagnosis, unadjusted analyses were conducted. Associations were strongest in children diagnosed with astrocytoma, ATRT, medulloblastoma, mixed glioma, or PNET before age 1 (HR range: 3.03-5.47) compared to other age groups (HR range: 1.25-3.07). Children with any major congenital anomaly have an increased risk of developing astrocytoma, ATRT, medulloblastoma, mixed glioma, or PNET, particularly by 1 year.

Exploring interaction effects of social determinants of health with hospital admission type on academic performance: a data linkage study

ObjectiveTo investigate the moderating effects of socio-demographic social determinants of health (SDH) in the relationship between types of childhood hospitalisation (ie, none, injury, non-injury, injury+non-injury) and academic performance.Design, setting and...

Comparing five-year and ten-year predicted cardiovascular disease risk in Aotearoa New Zealand: national data linkage study of 1.7 million adults.

There is no consensus on the optimal time horizon for predicting cardiovascular disease (CVD) risk to inform treatment decisions. New Zealand and Australia recommend 5 years, whereas most countries recommend 10 years. We compared predicted risk and treatment-eligible groups using 5-year and 10-year equations. Individual-level linked administrative datasets identified 1,746,665 New Zealanders without CVD, aged 30-74 years in 2006, with follow-up to 2018. Participants were randomly allocated to derivation and validation cohorts. Sex-specific 5-year and 10-year risk prediction models were developed in the derivation cohort and applied in the validation cohort. 28,116 (3.2%) and 62,027 (7.1%) first CVD events occurred during 5-years and 10-years follow-up respectively (cumulative risk, derivation cohort). Median predicted 10-year CVD risk (3.8%) was approximately 2.5 times 5-year risk (1.6%) and 95% of individuals in the top quintile of 5-year risk were also in the top quintile of 10-year risk, across age/gender groups (validation cohort). Using common guideline-recommended treatment thresholds (5% 5-year, 10% 10-year risk), approximately 14% and 28% of women and men respectively were identified as treatment-eligible applying 5-year equations compared to 17% and 32% of women and men applying 10-year equations. Older age was the major contributor to treatment eligibility in both sexes. Predicted 10-year CVD risk was approximately 2.5 times 5-year risk. Both equations identified mostly the same individuals in the highest risk quintile. Conversely, commonly used treatment thresholds identified more treatment-eligible individuals using 10-year equations and both equations identified approximately twice as many treatment-eligible men as women. The treatment threshold, rather than the risk horizon, is the main determinant of treatment eligibility.

Access to psychological therapies amongst patients with a mental health diagnosis in primary care: a data linkage study.

Significant numbers of people in England have fallen into a gap between primary care psychological therapies and specialist mental health services. We aim to examine pathways to care by looking at demographic variation in detection and referral to primary and secondary psychological services in south London. Longitudinal descriptive study using a record linkage between a primary care database (Lambeth DataNet) and a secondary care mental health database (CRIS). We extracted data on mental health diagnosis, prescriptions and episodes of care in mental health services for all patients of working age registered from 1 January 2008 to 1 March 2018 (pre-covid era). Of those with a mental disorder detected in primary care (n = 110,419; 26.8%); 33.7% (n = 37,253) received no treatment; 21.3% (n = 23,548) exclusively accessed psychological treatment within NHS Talking Therapies and 7.6% accessed secondary care psychological therapies. People from minoritised groups were more likely to be prescribed psychotropic medication as the only treatment offered compared to the White British group. Men, Black African and Asian groups were less likely to access NHS Talking Therapies. People with a personality disorder diagnosis had the highest prevalence and number of NHS Talking Therapies treatment episodes (48.0%, n = 960), a similar percentage (44.1%, n = 881) received secondary care psychology treatment. Our study highlights marked inequalities in access to psychological therapies for men and people from some minoritised ethnic groups across primary and secondary care and how individuals with personality disorders are offered multiple short-term courses in NHS Talking Therapies even where this is not recommended treatment.

A polygenic risk score model for psoriasis based on the protein interactions of psoriasis susceptibility loci.

Polygenic Risk Scores (PRS) are an emerging tool for predicting an individual's genetic risk to a complex trait. Several methods have been proposed to construct and calculate these scores. Here, we develop a biologically driven PRS using the UK BioBank cohort through validated protein interactions (PPI) and network construction for psoriasis, incorporating variants mapped to the interacting genes of 14 psoriasis susceptibility (PSORS) loci, as identified from previous genetic linkage studies. We constructed the PPI network via the implementation of two major meta-databases of protein interactions, and identified variants mapped to the identified PSORS-interacting genes. We selected only European unrelated participants including individuals with psoriasis and randomly selected healthy controls using an at least 1:4 ratio to maximize statistical power. We next compared our PPI-PRS model to (i) clinical risk models and (ii) conventional PRS calculations through p-value thresholding. Our PPI-PRS model provides comparable results to both clinical risk models and conventional approaches, despite the incorporation of a limited number of variants which have not necessarily reached genome-wide significance (GWS). Exclusion of variants mapped to the HLA-C locus, an established risk locus for psoriasis resulted in highly similar associations compared to our primary model, indicating the contribution of the genetic variability mapped to non-GWS variants in PRS computations. Our findings support the implementation of biologically driven approaches in PRS calculations in psoriasis, highlighting their potential clinical utility in risk assessment and treatment management.

Risk factors for unintentional injury hospitalisation among Aboriginal and non-Aboriginal children in Australia's Northern Territory: A data linkage study.

Unintentional injuries are a leading cause of hospitalisation for children. This study investigated the incidence and associated risk factors for unintentional injury hospitalisation (UIH) among Aboriginal and non-Aboriginal children aged under 5 years in Australia's Northern Territory. This was a retrospective cohort study using linked data from a perinatal register, hospital admissions, school enrolment and child protection services. The outcome variable was a first UIH. Potential risk factors included gender, pregnancy and birth outcomes, maternal education level, child protection service contact and geographic remoteness. Modified Poisson regression was used for multivariate modelling. A cohort of 21,189 children (54.0% Aboriginal) born between 2000 and 2010 were followed to the age of 5 years. The overall incidence of first UIH was 25.8 per 1,000 person-years, which was 28.6% higher among Aboriginal than non-Aboriginal children (28.8 and 22.4 per 1000 person-years, respectively). Risk factors identified in the full model included: being male (incidence rate ratio (IRR) 1.26, 95%CI: 1.17-1.36); living in a remote (IRR 1.26, 95%CI: 1.14-1.40) or very remote area (IRR 1.44, 95%CI: 1.29-1.59); having a notification or substantiated notification for abuse (IRR 1.42, 95%CI: 1.27-1.58 and IRR 1.60, 95%CI: 1.41-1.82, respectively); or neglect (IRR 1.32, 95%CI: 1.17-1.48 and IRR 1.28, 95%CI: 1.11-1.47, respectively). After adjustment, there was no difference in UIH rates between Aboriginal and non-Aboriginal children. In both stratified models, being male, living in remote or very remote areas and having a notification or substantiated notification for child maltreatment were identified as risk factors. Our study found high UIH incidence rates and evidence for an association between UIH and child maltreatment. This suggests child maltreatment and UIH have shared determinants and points to the need for clinicians to be aware of the overlap between these conditions and the importance of cross-agency collaboration in prevention and management.