Age, gender, and residence differences in prevalence and patterns of multimorbidity among older Chinese: Evidence from Chinese Longitudinal Healthy Longevity Survey

Background With the dramatic acceleration of ageing in China, multimorbidity among the older adults has become increasingly common，which are associated with more functional decline and higher health care utilization and mortality. Understanding demographic differences of patterns of multimorbidity is in favor of making targeted intervention strategies. The purpose of this study was to reveal age- specific, gender- specific, and residence- specific prevalence and patterns of multimorbidity among older adults in China. Methods The present analysis is based on the 2018 wave of Chinese Longitudinal Health Longevity Survey (CLHLS). We selected 13 chronic diseases from the CLHLS survey, and information was collected based on self-report. Multimorbidity was defined as the coexistence of two or more chronic diseases from 13 chronic diseases in the same individual. Descriptive statistical analysis was used to examine multimorbidity according to age, sex, and residence. Patterns and trends of chronic disease pairs and multimorbidity were explored using association rule mining. Results 9,660 individuals aged 65-117 years in the CLHLS were analyzed in this study. Overall, 74.4% of all participants had one or more morbidities, and 42.4% were multimorbid. The prevalence of individual chronic diseases ranged from 1.5% for cancer to 41.8% for hypertension, and each disease was often accompanied by one or more other chronic diseases. The prevalence of multimorbidity does not always increase with age. The subgroups with the highest prevalence of multimorbidity was 80-89 years old (48.2%), female (45.0%) and urban (47.2%) group. Prevalence of the hypertension- diabetes pattern decreases with age and is higher in women than in men. The prevalence of hypertension- depression pattern was at the highest among the 90-117 years and rural older adults, while the other groups were hypertension-heart disease. Moreover, it was noteworthy that the multimorbidity rate of dyslipidemia is the highest at 95.5% among the 13 chronic diseases. Conclusions The prevalence of multimorbidity among older Chinese was substantial, and patterns of multimorbidity differed in age, sex, and residence. Future efforts are needed to identify possible prevention strategies and guidelines targeted demographic differences of multimorbid patients to promote health in older adults.

Determinants affecting utilisation of health services and treatment for children under-5 in rural Nepali health centres: a retrospective cohort study

Background: Large inequalities in child health remain in Nepal, with caste, ethnicity and sex being major determinants of deprivation and negative outcomes. The purpose of this study was to explore whether key demographics on under 5s were associated with health seeking behaviours, utilisation of health care, and treatment received.Methods: Data came from Integrated Management of Neonatal & Childhood Illness (IMNCI) records of 23 health centres across five districts. After digitising the paper records, district, ethnicity, sex, age and temperature of the child were used to predict the number of days taken to seek medical care for Acute Respiratory Infection (ARI), diarrhoea and fever. In addition to this, correct diagnosis and subsequent treatment of pneumonia was assessed against IMNCI guidelines, again using the demographic factors of interest to predict these outcomes.Results: From 116 register books spanning 23 health centres, 33,860 child patient records were considered for analysis. The median age of attendance was 16 months (Inter-Quartile Range= 9, 30), while there were more male children that attended (55.8% vs. 44.2% for females). There were statistically significant differences for the time taken to attend a health centre between different districts for ARI, diarrhoea and fever, with children in the remote Humla and Mugu districts taking significantly longer to present at a health facility after the onset of symptoms (all p<0.012). Children from underprivileged ethnic groups, Madhesi and Dalit, were less likely to be given a correct diagnosis of pneumonia (p=0.001), while males were more likely to receive a correct diagnosis than females (73% vs. 67%, p=0.001). This sex difference remained in the adjusted regression models for diagnosis of pneumonia (p=0.011) but not for treatment of pneumonia (p=0.202).Conclusions: Significant demographic differences were found based on ethnicity, sex, and district when examining health seeking behaviours for ARI, diarrhoea, and fever. Significant associations were seen for these same factors when exploring accuracy of diagnoses of pneumonia, but not for treatment. This study has emphasised the importance of a digitalised healthcare system, where inequalities can be identified without the reliance on anecdotal evidence.

Rape Stereotype Acceptance in the General Population of England and Wales

The #MeToo movement has facilitated a growing awareness in the UK of rape stereotypes but there has been little research on how accurately rape is perceived in this region, especially regarding demographics such as ethnicity and age. This study recruited 1,000 participants, representative of the UK population, to complete an online survey prompting beliefs about rape perpetrators, rape victims, rape allegations, male rape, and motives for and consequences of rape. After carrying out frequency analyses on agree-incorrect and disagree-incorrect statements, we found that, generally, accuracy was high, although there were higher levels of stereotype acceptance for perpetrator related stereotypes. Further analysis found that in terms of demographic differences, Black and Asian participants and men were significantly more likely to accept stereotypes than other demographic groups. Implications for policy and practice are discussed, including potential for jury education, and educational media campaigns aimed at the demographics most likely to accept stereotypes.

Association of Hidradenitis Suppurativa (HS) with Autoimmune Disease and Autoantibodies

Objective There is thought to be an association between Hidradenitis Suppurativa (HS) and autoimmune diseases. This retrospective longitudinal cohort study looked to identify whether certain autoimmune diseases or autoantibody specificities are more closely associated with HS than others and, whether such associations are related to severity of HS. Methods Patients were identified using the SlicerDicer search tool in Epic from January 1, 2010 through August 15, 2020. Search criteria included HS diagnosis by ICD-10 code and at least one visit in dermatology. Charts were reviewed to determine HS disease severity, treatment modalities, presence of autoimmune disease, and autoantibody positivity. Results 627 patients were identified. Most patients were females (75.3%) and had obese BMIs (71.1%), but there were no significant demographic differences between HS patients with and without autoimmune diseases. 101 (16.1%) patients in the total cohort had at least one autoimmune disease, most commonly, thyroid disease, lupus, psoriasis, and inflammatory bowel disease (IBD). 212 patients were also tested for the presence of autoantibodies. The most common positive autoantibody, found in 54 patients (28.4%), was antinuclear antibody (ANA). 54 patients with more severe HS disease manifestations required biologic medications to treat their HS. Neither HS severity nor biologic treatment was associated with presence of autoimmune disease or positive autoantibodies. Conclusion In a large cohort of patients with HS followed longitudinally, autoimmune disorders (especially lupus, psoriasis and IBD) and presence of autoantibodies were more commonly observed than expected in the normal population.

Global similarity, and some key differences, in the metagenomes of Swedish varroa-surviving and varroa-susceptible honeybees

There is increasing evidence that honeybees (Apis mellifera L.) can adapt naturally to survive Varroa destructor, the primary cause of colony mortality world-wide. Most of the adaptive traits of naturally varroa-surviving honeybees concern varroa reproduction. Here we investigate whether factors in the honeybee metagenome also contribute to this survival. The quantitative and qualitative composition of the bacterial and viral metagenome fluctuated greatly during the active season, but with little overall difference between varroa-surviving and varroa-susceptible colonies. The main exceptions were Bartonella apis and sacbrood virus, particularly during early spring and autumn. Bombella apis was also strongly associated with early and late season, though equally for all colonies. All three affect colony protein management and metabolism. Lake Sinai virus was more abundant in varroa-surviving colonies during the summer. Lake Sinai virus and deformed wing virus also showed a tendency towards seasonal genetic change, but without any distinction between varroa-surviving and varroa-susceptible colonies. Whether the changes in these taxa contribute to survival or reflect demographic differences between the colonies (or both) remains unclear.

O-B02 Robotic versus Laparoscopic Roux-en-Y Gastric Bypass: A comparison of short-term outcomes and weight loss

Background The benefits of robotic over laparoscopic surgery for Roux-en-Y gastric bypass (RYGB) are debatable, with current evidence suggesting no significant differences in short-term outcomes. This study compares short-term outcomes and excess weight loss (EWL) % difference between these two techniques. Methods A retrospective study of patients undergoing RYGB between January 2016 and November 2020 at a single centre. Demographic, peri-operative and EWL% data were analysed. Results 424 RYGB procedures were performed by three surgeons including 77 robotic (RRYGB) and 347 laparoscopic (LRYGB) operations. The first 8 RRYGB were excluded being early in the learning curve and the operative technique was modified afterwards. There were no statistically significant demographic differences. The median operative time was 179 (151 – 195) and 149 (123 -171) minutes in the RRYGB and LRYGB groups respectively (P &lt; 0.001). There were no statistically significant differences between both groups in complications, length of stay, 30-day readmission and EWL% at 6 and 12 months. The EWL% at 2 years was 88.5 (+/-19.1) and 66.6 (+/-29.8) in the RRYGB and LRYGB groups respectively (P = 0.003). Conclusions RRYGB increases the operative time with no significant short-term outcome differences. The EWL% was higher at 2 years, probably due to a narrower hand-sewn gastro-jejunal anastomosis.

DNA barcodes evidence the contact zone of eastern and western caddisfly lineages in the Western Carpathians

The region of the Western Carpathians is, among other aspects, very important for survival and diversity of European freshwater fauna due to the presence of a large number of (sub)mountain springs and streams. However, these ecologically and faunistically diversified habitats are still understudied in the context of genetic diversity and population structure of their inhabitants. This study focuses on genetic diversity and distribution patterns of the caddisfly Rhyacophila tristis, common and widespread representative of mountain freshwater fauna. Analysis of the COI mitochondrial marker revealed presence of the western and eastern lineages, with samples from both lineages being grouped in BOLD (Barcode of Life Data System) into separate BINs (Barcode Index Numbers). Our data indicates that eastern lineage (BIN_E) is more closely related to the Balkan populations than to co-occurring western lineage (BIN_W), and that the contact zone of the lineages passes through the W Carpathians. The study revealed phylogeographic and demographic differences between lineages, supporting hypothesis of their evolutionary independence and specific ecological preferences. The obtained genetic data of the R. tristis population from W Carpathians improved our knowledge about population genetics of this aquatic species and can contribute to understanding the state and evolution of biodiversity of freshwater ecosystems in Europe.

Demographic Variation in Chronic Rhinosinusitis by Subtype and Region: A Systematic Review

Background Chronic rhinosinusitis (CRS) describes a heterogenous group of diseases including CRS with (CRSwNP) or without nasal polyps (CRSsNP), aspirin-exacerbated respiratory disease (AERD), and allergic fungal rhinosinusitis (AFRS). It affects 10 to 15% of the US population and is more common in women and White patients. However, these estimates are based on survey and database studies with innate diagnostic inaccuracy. Additionally, few studies report subtype-specific demographics. We explore the demographic differences of CRS in the U.S. by subtype and region. Objective To characterize demographic differences between the CRS population and the overall US population, and also between different CRS subtype populations. Methods We performed a systematic review for articles reporting on US demographics of adults with CRS. Study participants were required to have been diagnosed using consensus criteria. Data on demographics, geographic region, and CRS subtype were analyzed. Results Our study analyzed 31 unique studies representing 8409 patients with 50.7% females and weighted mean age of 48.0 years. Compared to the overall US population, CRS patients were predominantly White (78.5%) and non-Hispanic (94.5%) with under-representation of other races. Grouped by subtype, CRSwNP affected a significantly higher proportion of men (59.8%). AFRS affected a significantly higher proportion of Black patients (53.8%) while CRSsNP was more prevalent in White patients (84.2%). When grouped by region, the South had a significantly higher proportion of female (53%) and Black (17.8%) CRS patients. The West had a significantly higher proportion of Asian (4.5%) and Hispanic (12.3%) patients. Conclusions Significant demographic differences exist in CRS patients based on subtype and region. These data provide an estimation of the demographic make-up of CRS, but further high-level demographic studies are needed.

Bridging Troubled Times

The current labor market has produced manifold crises with high unemployment rates and increasing worklife dynamics. Adaptability and identity are metaskills that enable the learning process necessary to overcome obstacles on the career path. The contribution of this review lies in its focus on the question of whether the metaskills of career adaptability and identity can serve to bridge troubled times for everyone in the working population. This review provides a conceptual model of a “decent career” that acknowledges challenging circumstances based on demographic differences (e. g., age, ethnicity, sex) or structural conditions (e. g., economic crisis) and the antecedents necessary to foster individual skills that serve various beneficial outcomes.