851. Rate of Sexually Transmitted Infections and Engagement in HIV Pre-Exposure Prophylaxis at the Veterans Affair Maryland Health System

Background Rates of sexually transmitted infections (STIs) and uptake of HIV pre-exposure prophylaxis (PrEP) during the 2020 coronavirus pandemic are unknown. We evaluated data from the Veterans Affair Maryland Health Care System (VAMHCS) data to determine rates of STI and PrEP linkage in our Veterans. Methods We extracted patient-level data on demographics, STI testing (chlamydia, gonorrhea, and syphilis), International Classification of Diseases (ICD) diagnosis codes and refills of TDF-FTC and TAF-FTC. We compared the ratio of positive STI tests in 2018, 2019 and 2020 using chi-square tests. Individuals eligible for PrEP were defined as patients with a newly positive STI result or an ICD diagnosis of: high risk sexual behavior; an STI mentioned above; or gender identity disorder. We excluded anyone with a positive HIV test or a creatinine >1.8. We identified patients initiated on PrEP through pharmacy refill data to define initiation of care. Finally, we used chi-square tests to compare differences of initiation of PrEP between years and demographics. Results The STI positivity rate significantly increased (p< 0.01) from 44.2% (2018) and 42.9% (2019) to 61.6% (2020) [Table 1]. The median ages of those who had a positive STI test were 50 (2018), 44 (2019) and 44 (2020). In 2020, 17% of patients eligible for PrEP filled PrEP. Engagement was similar (p=0.33) in 2019 and 2018, where 14% and 11.6% of patients eligible for PrEP received a prescription (p-value=0.33) [Figure 1]. The median age of those refilling PrEP were: 44 (2018); 43 (2019) and 41 (2020)). In 2020, we observed a statistically significant difference (p< 0.01) in initiation of PrEP in care among Black patients with 11.7% of eligible patients filling PrEP as compared to white patients (26.2%) and other races (23.3%) [Figure 2]. Table 1. Rate of positive tests at VAMHCS from 2018-2020. Figure 1. PrEP Cascade at VAMHCS by year. Non-statistically significant (P=0.33) when comparing engagement in care between different years. Figure 2. Racial distribution of PrEP eligibility and initiation by year at the VAMHCS. Conclusion While during the coronavirus pandemic in 2020, fewer Veterans sought STI testing at the VAMHCS, the number of positive STI results remained steady, leading to a higher positivity rate. The rate of initiation of PrEP did not differ between 2020, 2019 and 2018. Racial inequities in initiation of PrEP increased in 2020. Disclosures All Authors: No reported disclosures

Evaluation of Government’s Efforts to Mitigate the Adverse Effects of Gas Flaring in Host Communities

Background: This is a 5th in the series on gas flaring in Niger Delta Nigeria and previous reports have highlighted health impact and comparison of communities, amongst others. Government have mitigation programs whose satisfaction in the communities of Niger Delta is unknown. Objective: The objective of this study is to evaluate government’s efforts at mitigation and adaptation whether there are age and/or gender differences Methods: This was a quantitative survey cross-sectional study that used Likert scale questionnaire to generate views of the community on the behavioural change wheel (BCW) as well as mitigation and adaptation efforts of the government. Respondents were stratified into age groups and dichotomized in female or male and analysis involved multivariate analysis (MANOVA) to evaluate age and gender differences. Chi-Square tests were performed to assess associations between BCW components mitigation versus adaptation. Results: A total of 435 respondents were included and the results show levels of inconsistent age and gender differences. Men tended to agree more on government’s BCW albeit not significance achieved, while women agreed more mitigation and adaptation (p < 0.02). On age, the silent generation (>70 years old) group agreed more on BCW, but contrarily disagreed on mitigation and adaptation while younger generation agreed on the latter (0.001). Chi-Square tests show significance for association. Conclusion: This report highlights divergent views of the community on the discourse of government’s efforts at mitigation and adaptation of gas flaring in Niger Delta Nigeria, thereby providing empirical evidence of generational gap on environmental issue.

Campus Smoking Policies and Smoking-Related Twitter Posts Originating From California Public Universities: Retrospective Study (Preprint)

BACKGROUND The number of colleges and universities with smoke- or tobacco-free campus policies has been increasing. The effects of campus smoking policies on overall sentiment, particularly among young adult populations, are more difficult to assess owing to the changing tobacco and e-cigarette product landscape and differential attitudes toward policy implementation and enforcement. OBJECTIVE The goal of the study was to retrospectively assess the campus climate toward tobacco use by comparing tweets from California universities with and those without smoke- or tobacco-free campus policies. METHODS Geolocated Twitter posts from 2015 were collected using the Twitter public application programming interface in combination with cloud computing services on Amazon Web Services. Posts were filtered for tobacco products and behavior-related keywords. A total of 42,877,339 posts were collected from 2015, with 2837 originating from a University of California or California State University system campus, and 758 of these manually verified as being about smoking. Chi-square tests were conducted to determine if there were significant differences in tweet user sentiments between campuses that were smoke- or tobacco-free (all University of California campuses and California State University, Fullerton) compared to those that were not. A separate content analysis of tweets included in chi-square tests was conducted to identify major themes by campus smoking policy status. RESULTS The percentage of positive sentiment tweets toward tobacco use was higher on campuses without a smoke- or tobacco-free campus policy than on campuses with a smoke- or tobacco-free campus policy (76.7% vs 66.4%, <i>P</i>=.03). Higher positive sentiment on campuses without a smoke- or tobacco-free campus policy may have been driven by general comments about one’s own smoking behavior and comments about smoking as a general behavior. Positive sentiment tweets originating from campuses without a smoke- or tobacco-free policy had greater variation in tweet type, which may have also contributed to differences in sentiment among universities. CONCLUSIONS Our study introduces preliminary data suggesting that campus smoke- and tobacco-free policies are associated with a reduction in positive sentiment toward smoking. However, continued expressions and intentions to smoke and reports of one’s own smoking among Twitter users suggest a need for more research to better understand the dynamics between implementation of smoke- and tobacco-free policies and resulting tobacco behavioral sentiment.

Evaluation of Quality of Root Canal Fillings Performed by Undergraduate Students of a Brazilian University / Avaliação da qualidade da obturação do canal radicular realizada por estudantes de graduação de uma Universidade brasileira

The aim of this study was to evaluate the quality of root canal filling performed by undergraduate students at the Federal University of Espirito Santo (UFES). A total of 368 periapical radiographs of endodontic treatment performed by undergraduate students between 2012 and 2014 was assessment. The quality of root canal filling was based on two criteria: length of root canal filling and adequate density of the obturation. Root canal fillings were considered adequate if had no voids and were located at 0-2 mm below the radiographic apex. Statistical analysis was conducted using chi-square tests, with a 5% significance level. In 93.8% of the cases the root canal filling was considered adequate. The density of the obturation was considered inadequate in 3% of the cases. When the length of root canal filling was observed, 1.2% of cases were considered as over-filled and 2.2% were considered under-filled. Non-significant differences were observed among the tooth type (incisive, canines and pre-molars) and the quality of root canal filling. Most of root canal filling performed by undergraduate students at the UFES were considered adequate, regardless of tooth type.

Đánh giá biến chứng của phẫu thuật đặt lại xương sọ: Tỷ lệ và các yếu tố liên quan

Mục tiêu: Đánh giá các biến chứng của phẫu thuật đặt lại bản sọ sau các phẫu thuật mở sọ giải áp và xác định mối liên quan với một số yếu tố nguy cơ. Đối tượng và phương pháp: Hồi cứu 202 bệnh nhân được phẫu thuật đặt lại bản sọ sau phẫu thuật mở sọ giải áp do các nguyên nhân khác nhau tại Bệnh viện Trung ương Quân đội 108, từ tháng 8 năm 2018 đến tháng 1 năm 2021. Tất cả các bệnh nhân đều được theo dõi ít nhất 6 tháng sau phẫu thuật. Các biến chứng chính được thống kê và đánh giá trong mối liên quan với một số yếu tố nguy cơ: Nguyên nhân mở sọ giải áp, các bệnh kèm theo (tăng huyết áp, tiểu đường, dùng thuốc chống đông), vị trí khuyết xương, thời điểm tiến hành phẫu thuật đặt lại bản sọ… Các thuật toán được sử dụng để phân tích bao gồm Student’s t-test, Chi-square tests và Fisher’s exact tests. Khoảng tin cậy được tính là 95%. Kết quả: Tỷ lệ biến chứng chung sau phẫu thuật là 23,26%. Các biến chứng thường gặp: Nhiễm trùng (6,44%), tiêu sập mảnh ghép (6,44%), động kinh (6,44%), chảy máu (3,46%). Thời gian đặt lại bản sọ sớm (trong vòng 3 tháng sau phẫu thuật giải áp) và sự rối loạn lưu thông dịch tủy là những yếu tố nguy cơ làm tăng tỷ lệ biến chứng (p<0,05). Một số yếu tố liên quan: Thời điểm đặt lại bản sọ sớm (< 3 tháng) liên quan đến tình trạng nhiễm trùng và tiêu sập mảnh ghép với giá trị p<0,05, thời điểm đặt lại bản sọ muộn có mối liên quan đến tình trạng động kinh (p=0,007). Sự rối loạn lưu thông dịch tủy có liên quan đến tình trạng động kinh và tiêu sập mảnh ghép (p<0,05). Kết luận: Mặc dù phẫu thuật tạo hình hộp sọ là một phẫu thuật đơn giản, nhưng nó thường có tỷ lệ biến chứng tương đối cao. Kiểm soát các yếu tố nguy cơ của bệnh nhân và nhận biết sớm các biến chứng có thể giúp các bác sĩ tránh được các biến chứng.

Accuracy and Cost-effectiveness of Technology-Assisted Dietary Assessment Comparing the Automated Self-administered Dietary Assessment Tool, Intake24, and an Image-Assisted Mobile Food Record 24-Hour Recall Relative to Observed Intake: Protocol for a Randomized Crossover Feeding Study (Preprint)

BACKGROUND The assessment of dietary intake underpins population nutrition surveillance and nutritional epidemiology and is essential to inform effective public health policies and programs. Technological advances in dietary assessment that use images and automated methods have the potential to improve accuracy, respondent burden, and cost; however, they need to be evaluated to inform large-scale use. OBJECTIVE The aim of this study is to compare the accuracy, acceptability, and cost-effectiveness of 3 technology-assisted 24-hour dietary recall (24HR) methods relative to observed intake across 3 meals. METHODS Using a controlled feeding study design, 24HR data collected using 3 methods will be obtained for comparison with observed intake. A total of 150 healthy adults, aged 18 to 70 years, will be recruited and will complete web-based demographic and psychosocial questionnaires and cognitive tests. Participants will attend a university study center on 3 separate days to consume breakfast, lunch, and dinner, with unobtrusive documentation of the foods and beverages consumed and their amounts. Following each feeding day, participants will complete a 24HR process using 1 of 3 methods: the Automated Self-Administered Dietary Assessment Tool, Intake24, or the Image-Assisted mobile Food Record 24-Hour Recall. The sequence of the 3 methods will be randomized, with each participant exposed to each method approximately 1 week apart. Acceptability and the preferred 24HR method will be assessed using a questionnaire. Estimates of energy, nutrient, and food group intake and portion sizes from each 24HR method will be compared with the observed intake for each day. Linear mixed models will be used, with 24HR method and method order as fixed effects, to assess differences in the 24HR methods. Reporting bias will be assessed by examining the ratios of reported 24HR intake to observed intake. Food and beverage omission and intrusion rates will be calculated, and differences by 24HR method will be assessed using chi-square tests. Psychosocial, demographic, and cognitive factors associated with energy misestimation will be evaluated using chi-square tests and multivariable logistic regression. The financial costs, time costs, and cost-effectiveness of each 24HR method will be assessed and compared using repeated measures analysis of variance tests. RESULTS Participant recruitment commenced in March 2021 and is planned to be completed by the end of 2021. CONCLUSIONS This protocol outlines the methodology of a study that will evaluate the accuracy, acceptability, and cost-effectiveness of 3 technology-enabled dietary assessment methods. This will inform the selection of dietary assessment methods in future studies on nutrition surveillance and epidemiology. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN12621000209897; https://tinyurl.com/2p9fpf2s INTERNATIONAL REGISTERED REPORT DERR1-10.2196/32891

Comparison of Healthiness, Labelling, and Price between Private and Branded Label Packaged Foods in New Zealand (2015–2019)

We aimed to compare New Zealand private label (PL) and branded label (BL) packaged food products in relation to their current (2019) healthiness (sodium and sugar contents, and estimated Health Start Rating (HSR) score), display of the voluntary HSR nutrition label on the package, and price. Healthiness and HSR display of products were also explored over time (2015 to 2019). Data were obtained from Nutritrack, a brand-specific food composition database. Means and proportions were compared using Student t-tests and Pearson chi-square tests, respectively. Changes over time were assessed using linear regression and chi-square tests for trends (Mantel–Haenzel tests). Altogether, 4266 PL and 19,318 BL products across 21 food categories were included. Overall, PL products in 2019 had a significantly lower mean sodium content and price, a higher proportion of products with estimated HSR ≥ 3.5/5 (48.9% vs. 38.5%) and were more likely to display the HSR on the pack compared with BL products (92.4% vs. 17.2%, respectively). However, for most food categories, no significant difference was found in mean sodium or sugar content between PL and BL products. In the period 2015–2019, there were no consistent changes in estimated HSR score, sodium or sugar contents of PL or BL products, but there was an increase in the proportion of both PL and BL products displaying HSR labels. In most food categories, there were PL options available which were similar in nutritional composition, more likely to be labelled with the HSR, and lower in cost than their branded counterparts.

Age at First Conception and its Determinants of Ever-Married Women in Bangladesh

Age at first conception is an important part of the reproductive process that identifies the level of fecundability and indicative fertility during the early stages of marriage. This study explores the age at first conception and its determinants of ever-married women in Bangladesh by extracting the recent Bangladesh Demographic and Health Surveys (BDHS 2017) data. Descriptive statistics, ANOVA, chi-square tests, and binary logistic regression analysis were carried out to analyze data. Overall, the mean age at first conception of Bangladeshi women is 17.82 ± 3.29 years with significant variations by different socio-demographic, cultural, and behavioral factors. Bivariate analysis of chi-square tests shows that all the independent variables have a significant effect on age at first conception. The finding of the binary logistic regression analysis revealed that respondents' current age, age at first cohabitation, respondents' education, and partners' education are the most important determinants of age at first conception in Bangladesh. Moreover, secondary (OR= 0.743, 95% CI = 0.622- 0.886, P < 0.01) and higher educated women (OR= 0.838, 95% CI = 0.710- 0.989, P < 0.05) were respectively less likely to having first conception at age above 17.25 years, compared to no educated women. Thus, to increase the age at the first conception and reduce the level of fertility, it is necessary to increase the age at the first marriage of the respondents and the level of education for both partners.

Fire Disaster Preparedness among Residents in a High Income Community

Fire disaster preparedness (FDP) is of paramount importance in preventing the globe’s most prevalent disaster. This has been a big issue for developing nations. The study investigated FDP among residents in a high-income community of a part in Southwestern Nigeria. The aim of the study was to identify the preparedness of residents regarding fire disasters in residential buildings in Parakin, Ife Central Local Government Area of Osun State, Nigeria. To achieve the objectives, a quantitative study was carried out, primary data was sourced from structured, self-administered questionnaires. 80 buildings was purposively selected for the study. Affiliated literature was reviewed. Descriptive statistical tools such as frequency distribution and percentage was used in analysing the data. Chi-square tests at a significance level of 0.05 was done. SPSS version 23.0 was used in analysing all the data. Findings revealed that FDP is very low in the study area as respondents have very little or no firefighting facilities or gadgets, awareness, training about FDP. Chi-square tests revealed that there was no statistical significance between age of respondents and preparedness, ownership of home and preparedness, education and preparedness and sex and preparedness. It was established that preparedness for fire is very low. The study, however, recommended the provision of active and passive fire protection facilities in buildings, proper training of building users on FDP, enabling laws are also needed to promote the installation of fire protection, prevention, detection and suppression.

Generational differences in the placement of clitic se in New York City Spanish

Aims and objectives: This study analyzes the proclitic and enclitic positions of Spanish clitic se (e.g., ella se quería ir / ella quería irse ‘she wanted to go’) across two generations of Spanish speakers in New York City. In an effort to contribute to ongoing research aimed at better understanding Spanish in the US, the following questions are addressed. In syntactic environments that permit variation, does placement of Spanish se differ between the two generations? From the internal variables identified for this study (nonfinite verb type, finite verb, tense of finite verb, grammatical person, use of se, grammatical mood of finite verb, negation), which ones have a statistically significant effect on placement? From the external variables identified for this study (national origin, region, areal origins, sex, age, years in US, socioeconomic class, education, English skill, Spanish skill, general Spanish use), which ones have a statistically significant effect on placement? Design and data: This study is carried out within a variationist-sociolinguistic framework and the sample consists of 50 participants, 25 from the first generation (G1) and 25 from the second (G2). Analysis: Bivariate chi-square tests are performed in order to determine what internal and external variables constrain placement of the dependent variable (clitic se placement). Findings: Generation has a statistically significant effect on placement ( p = .016), wherein proclisis is more frequent amongst the G2 participants. These results corroborate previous research showing an overall preference for proclisis in both monolingual and bilingual/heritage speakers. Further, chi-square tests pinpoint five conditioning effects for G1 (nonfinite verb type, use of se, finite verb, years in US, and English skill), but only two for G2 (use of se and English skill). Originality and implications: The present study is the first to discover strong correlations between the proclitic position and the numerous internal and external variables quantitatively assessed. Future research is thus warranted.