Doxycycline exposure during adolescence and future risk of non-affective psychosis and bipolar disorder: a total population cohort study

Doxycycline has been hypothesized to prevent development of severe mental illness (SMI) through the suppression of microglia, especially if administered during the intense synaptic pruning period of adolescence. However, results from register studies on potential benefits differ considerably. The aim of the present study was to determine whether doxycycline exposure during adolescence is associated with reduced SMI risk, and to investigate if a direct and specific causality is plausible. This is a Swedish national population register-based cohort study of all individuals born from 1993 to 1997, followed from the age of 13 until end of study at the end of 2016. The primary exposure was cumulative doxycycline prescription ≥3000 mg and outcomes were first diagnosis of non-affective psychosis (F20–F29) and first diagnosis of bipolar disorder (F30–F31). Causal effects were explored through Cox regressions with relevant covariates and secondary analyses of multilevel exposure and comparison to other antibiotics. We found no association between doxycycline exposure and risk of subsequent non-affective psychosis (adjusted hazard ratio (HR) 1.15, 95% CI 0.73–1.81, p = 0.541) and an increased risk of subsequent bipolar disorder (adjusted HR 1.95, 95% CI 1.49–2.55, p < 0.001). We do not believe the association between doxycycline and bipolar disorder is causal as similar associations were observed for other common antibiotics.

Rapid mortality surveillance using a national population register to monitor excess deaths during SARS-CoV-2 pandemic in South Africa

This paper describes how an up-to-date national population register recording deaths by age and sex, whether deaths were due to natural or unnatural causes, and the offices at which the deaths were recorded can be used to monitor excess death during the SARS-CoV-2 pandemic, both nationally, and sub-nationally, in a country with a vital registration system that is neither up to date nor complete. Apart from suggesting an approach for estimating completeness of reporting at a sub-national level, the application produces estimates of the number of deaths in excess of those expected in the absence of the SARS-CoV-2 epidemic that are highly correlated with the confirmed number of COVID-19 deaths over time, but at a level 2.5 to 3 times higher than the official numbers of COVID-19 deaths. Apportioning the observed excess deaths more precisely to COVID, COVID-related and collateral deaths, and non-COVID deaths averted by interventions with reduced mobility and gatherings, etc., requires access to real-time cause-of-death information. It is suggested that the transition from ICD-10 to ICD-11 should be used as an opportunity to change from a paper-based system to electronic capture of the medical cause-of-death information.

Gauging Opinions About the Citizenship Amendment Act and NRC

Today, the advent of social media has provided a platform for expressing opinions regarding legislation and public schemes. One such burning legislation introduced in India is the Citizenship Amendment Act (CAA) and its impact on the National Citizenship Register (NRC) and, subsequently, on the National Population Register (NPR). This study examines and determines the opinions expressed on social media regarding the act through a Twitter analysis approach that extracts nearly 18,000 tweets during 10 days of introducing the scheme. The analysis revealed that the opinion was neutral but tended to a more negative reaction. Consequently, recommendations on improving public perception about the scheme by suitable for interpreting the Act to the public are provided in the paper.

Seroprevalence of antibodies against SARS-CoV-2 virus in the adult Norwegian population, winter 2020/2021: pre-vaccination period

Since early 2020, over 123 million people worldwide have been diagnosed with coronavirus disease (Covid-19), but the true number of infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is undoubtedly higher. The seroprevalence of antibodies against SARS-CoV-2 can provide crucial epidemiological information about the extent of infections independent of virologically detected case numbers. There is no large population-based SARS-CoV-2 seroprevalence survey from Norway; thus we estimated SARS-CoV-2 seroprevalence in Norway before the introduction of vaccines and described its distribution across demographic groups. In November-December 2020, a total of 110,000 people aged 16 years or older were randomly selected from the National Population Register and invited to complete a questionnaire and provide a dried blood spot (DBS) sample. The response rate was 30%; compliance rate for return of DBS samples was 88%. The national weighted and adjusted seroprevalence was 0.9% (confidence interval 0.7-1.0).Seroprevalence was highest among those aged 16-19 years (1.9%, 0.9-2.9), those born outside the Nordic countries 1.4% (1.0-1.9), and in the counties of Oslo 1.7 % (1.2-2.2) and Vestland 1.4% (0.9-1.8). The ratio of SARS-CoV-2 seroprevalence (0.9) to the cumulative incidence of virologically detected cases by mid-December 2020 (0.8%) was slightly above one. SARS-CoV-2 seroprevalence was low before the introduction of vaccines in Norway and was comparable to virologically detected cases, indicating that most cases in the first 10 months of the pandemic were detected. Preventive measures including contact tracing have been effective, people are complying with social distancing recommendations, and local efforts to contain outbreaks have been essential.

Citizens, Infiltrators, and Others

This article will address the political objective behind the Modi government passing the Citizenship Amendment Act (CAA), planning to prepare a National Population Register (NPR) and a National Register of Citizens (NRC). It will examine the psychological impact of these moves on the minority community and why these moves were seen as precursors to their possible political disenfranchisement. It will examine the manner in which anti-CAA/NPR/NRC protest sites came up spontaneously across the country, how these protests were organized, and their lack of a clear leadership. It will also examine the decision of mainstream Opposition parties to keep away from these protests and the consequences of this decision. It will argue that this decision cost the political parties and the nation dearly. It shifted the political discourse within the majoritarian spectrum and led to these parties losing credibility with the protestors and the minority community. Finally, it will also examine the failure of the mainstream political parties in preventing violence by the state against the protestors (such as in Uttar Pradesh, Karnataka and Delhi) and in moderating the protests so that they do not fall prey to violent provocation.

O6E.5 Occupation and risk of amyotrophic laterals sclerosis (ALS) in denmark

IntroductionAmyotrophic lateral sclerosis (ALS) is a rare and complex neurodegenerative disease, which is highly fatal. It is known that 5%–10% of ALS cases are hereditary, but apart from this the causes for sporadic of ALS are unknown. Some evidence, however, suggests that manifestation and progression may be associated with certain occupational exposures, e.g. exposure to formaldehyde, lead and military service. The aim of this study is to survey the occupational risk of ALS in Denmark based on nationwide registries.MethodsWe identified 1826 ALS cases who were 25 years old or less in 1964 and diagnosed from 1982 to 2013 from the Danish National Patient Registry, which cover all hospitals in Denmark. We matched 100 ALS free population controls to each case based on birth year and sex. Information on demographic data were obtained from the national Population Register and linked by the unique personal indentifier, assigned to all residents, to the Danish Pension Fund (DPF) to determine individual employment history from 1964. All employees in Denmark are compulsory members of DPF. Conditional logistic regression models were uses for estimation of odds ratios OR and their 95% confidence intervals, adjusted for socioeconomic status, marital status and residential location.ResultsWe observed increased OR of ALS among men who worked in e.g. agriculture, hunting, forestry or fishing (OR=1.2; 1.0–1.5). There was also a positive association for men employed in construction (OR=1.2; 1.1–1.4). In women, no significant increases were observed, but a protective association was seen with employment in the cleaning industry (OR=0.7; 0.5–0.9).ConclusionsOur study shows various occupations with exposure to toxicants, such as diesel exhaust and lead, and strenuous physical activity associated with increased odds of ALS in men. Future studies should have a particular focus on gathering detailed information on physical exertion and exposure to specific chemicals.

The Norwegian Historic Population Register and Migration

This article describes the development of the Norwegian Historical Population Register, which is the first open national register. In the period 1735–1964, 9.7 million people lived in Norway, and for them 37.5 million events (such as birth, death, or migration) have been recorded in sources. We link together as many events as possible for the same persons and families, but only include links that have a high probability of being correct. The linking is performed by automatic methods and crowdsourcing. A national population register is important for migration research. It allows us to reconstruct (stepwise) internal migration in Norway, frequently followed by international migration from Norway, as well as return migration to Norway. Many non-Norwegian sources also specify place of birth by country, and this makes it possible to identify individuals in Norwegian sources.

Probabilistic linkage of national immunisation and state-based health records for a cohort of 1.9 million births to evaluate Australia’s childhood immunisation program

IntroductionSeveral countries have developed national immunisation registers, but only the Nordic countrieshave linked their registers to other health data in order to comprehensively evaluate the ‘real world’effectiveness of vaccines. Nordic countries can link datasets deterministically using the nationalperson identifier, but most countries, including Australia, don’t have such an identifier to enablethis type of linkage. ObjectivesTo describe the process for assembling a linked study cohort that will enable the conduct ofpopulation-based studies related to immunisation and immunisation policy. MethodsNational death and immunisation databases along with state health data (notifications of vaccinepreventable diseases, perinatal data, hospital admissions and emergency department presentations)up until December 2013 were probabilistically linked (using demographic details) for children bornbetween 1996 and 2012 in two states: Western Australia and New South Wales (42% of Australia’spopulation, combined). ResultsAfter exclusions there were 1.95 million children in the study cohort (live born children withboth a birth and perinatal record which represents 97.5% of all live births in the state perinataldata collections - our source population) and 18.0 million person years of follow up (mean: 9.2years per child). The characteristics of children in the cohort were generally similar to those onlyincluded in state perinatal databases and outcome measures were in keeping with expected figuresfrom unlinked data sources. However, the lack of a dynamic national population register meantimmigrants could not be included. ConclusionsWe have been able to develop a similarly comprehensive system to the Nordic countries based onprobabilistic linkage methods. Our experience should provide encouragement to other countrieswith national immunisation registers looking to establish similar systems.

Good work ability among unemployed individuals: Association of sociodemographic, work-related and well-being factors

Aims: The aims of this study were to describe the perceived work ability of unemployed individuals and to explore the association between perceived good work ability and sociodemographic, work-related and well-being factors. Methods: The data were derived from the Finnish Regional Health and Well-being Study (ATH) collected by postal and Internet-based questionnaires in 2014–2015. The random sample was selected from the Finnish National Population Register. The present study includes data from unemployed or laid-off respondents ( n=1975) aged 20–65 years. Logistic regression was used in the statistical analysis. Perceived work ability was measured with the Work Ability Score. Results: Factors significantly associated with good work ability were having young children living in the household, short-term unemployment, low or moderate physical strain in most recent job, moderate mental strain in most recent job, satisfaction with most recent job, good self-rated health and good quality of life. Good self-rated health (odds ratio=10.53, 95% confidence interval 5.90–18.80) was the most substantial factor in the multivariate model. Conclusions:The findings provide further evidence on the factors related to good work ability of the unemployed. These factors should be considered when designing interventions for promoting work ability and to minimise the harmful effects of long-term unemployment.