Factors influencing wellbeing in young people during COVID-19: A survey with 6291 young people in Wales

COVID-19 infection and the resultant restrictions has impacted all aspects of life across the world. This study explores factors that promote or support wellbeing for young people during the pandemic, how they differ by age, using a self-reported online survey with those aged 8–25 in Wales between September 2020 and February 2021. Open-ended responses were analysed via thematic analysis to provide further context. A total of 6,291 responses were obtained from 81 education settings across Wales (including primary and secondary schools as well as sixth form, colleges and universities). Wellbeing was highest in primary school children and boys and lowest in those who were at secondary school children, who were girls and, those who preferred not to give a gender. Among primary school children, higher wellbeing was seen for those who played with lots of others (rather than alone), were of Asian ethnicity (OR 2.17, 95% CI: 1.26 to 4.3), had a safe play area (OR: 2.4, 95% CI: 1.67 to 2.56) and had more sleep. To support their wellbeing young people reported they would like to be able to play with their friends more. Among secondary school children those who were of mixed ethnicity reported lower wellbeing (OR: 5.14, 95% CI: 1.68 to 15.79). To support their wellbeing they reported they would like more support with mental health (due to anxiety and pressure to achieve when learning online). This study found self-reported wellbeing differed by gender, ethnicity and deprivation and found younger children report the need for play and to see friends to support wellbeing but older children/young people wanted more support with anxiety and educational pressures.

Unseen Artificial Intelligence—Deep Learning Paradigm for Segmentation of Low Atherosclerotic Plaque in Carotid Ultrasound: A Multicenter Cardiovascular Study

Background: The early detection of carotid wall plaque is recommended in the prevention of cardiovascular disease (CVD) in moderate-risk patients. Previous techniques for B-mode carotid atherosclerotic wall plaque segmentation used artificial intelligence (AI) methods on monoethnic databases, where training and testing are from the “same” ethnic group (“Seen AI”). Therefore, the versatility of the system is questionable. This is the first study of its kind that uses the “Unseen AI” paradigm where training and testing are from “different” ethnic groups. We hypothesized that deep learning (DL) models should perform in 10% proximity between “Unseen AI” and “Seen AI”. Methodology: Two cohorts from multi-ethnic groups (330 Japanese and 300 Hong Kong (HK)) were used for the validation of our hypothesis. We used a four-layered UNet architecture for the segmentation of the atherosclerotic wall with low plaque. “Unseen AI” (training: Japanese, testing: HK or vice versa) and “Seen AI” experiments (single ethnicity or mixed ethnicity) were performed. Evaluation was conducted by measuring the wall plaque area. Statistical tests were conducted for its stability and reliability. Results: When using the UNet DL architecture, the “Unseen AI” pair one (Training: 330 Japanese and Testing: 300 HK), the mean accuracy, dice-similarity, and correlation-coefficient were 98.55, 78.38, and 0.80 (p < 0.0001), respectively, while for “Unseen AI” pair two (Training: 300 HK and Testing: 330 Japanese), these were 98.67, 82.49, and 0.87 (p < 0.0001), respectively. Using “Seen AI”, the same parameters were 99.01, 86.89 and 0.92 (p < 0.0001), respectively. Conclusion: We demonstrated that “Unseen AI” was in close proximity (<10%) to “Seen AI”, validating our DL model for low atherosclerotic wall plaque segmentation. The online system runs < 1 s.

Type 2 diabetes risks and determinants in second-generation migrants and mixed ethnicity people of South Asian and African Caribbean descent in the UK

Aims/hypothesis Excess risks of type 2 diabetes in UK South Asians (SA) and African Caribbeans (AC) compared with Europeans remain unexplained. We studied risks and determinants of type 2 diabetes in first- and second-generation (born in the UK) migrants, and in those of mixed ethnicity. Methods Data from the UK Biobank, a population-based cohort of ~500,000 participants aged 40–69 at recruitment, were used. Type 2 diabetes was assigned using self-report and HbA1c. Ethnicity was both self-reported and genetically assigned using admixture level scores. European, mixed European/South Asian (MixESA), mixed European/African Caribbean (MixEAC), SA and AC groups were analysed, matched for age and sex to enable comparison. In the frames of this cross-sectional study, we compared type 2 diabetes in second- vs first-generation migrants, and mixed ethnicity vs non-mixed groups. Risks and explanations were analysed using logistic regression and mediation analysis, respectively. Results Type 2 diabetes prevalence was markedly elevated in SA (599/3317 = 18%) and AC (534/4180 = 13%) compared with Europeans (140/3324 = 4%). Prevalence was lower in second- vs first-generation SA (124/1115 = 11% vs 155/1115 = 14%) and AC (163/2200 = 7% vs 227/2200 = 10%). Favourable adiposity (i.e. lower waist/hip ratio or BMI) contributed to lower risk in second-generation migrants. Type 2 diabetes in mixed populations (MixESA: 52/831 = 6%, MixEAC: 70/1045 = 7%) was lower than in comparator ethnic groups (SA: 18%, AC: 13%) and higher than in Europeans (4%). Greater socioeconomic deprivation accounted for 17% and 42% of the excess type 2 diabetes risk in MixESA and MixEAC compared with Europeans, respectively. Replacing self-reported with genetically assigned ethnicity corroborated the mixed ethnicity analysis. Conclusions/interpretation Type 2 diabetes risks in second-generation SA and AC migrants are a fifth lower than in first-generation migrants. Mixed ethnicity risks were markedly lower than SA and AC groups, though remaining higher than in Europeans. Distribution of environmental risk factors, largely obesity and socioeconomic status, appears to play a key role in accounting for ethnic differences in type 2 diabetes risk. Graphical abstract

Socio-demographic and clinical characterization of intestinal ostomized people: an integrative literature review

This study aims to identify and analyze the sociodemographic and clinical characteristics of people with intestinal ostomy in the Brazilian literature. This is an Integrative Review of Scientific Literature, whose search for studies occurred in the following databases: Lilacs, CINAHL, PubMed/MedLine, BDENF, Scopus, SciELO Virtual Library and reverse search of selected articles. Of the 14 articles compiled, 78.57% have a descriptive design; the Lilacs database had the highest number of articles (64.28%); the Revista Brasileira de Coloproctologia was the one that published the most (42.85%), with a predominance of publications equally in the years 2017 and 2018 (21.42%); the Northeast region predominated in the number of articles published (49.98%). The predominant age ranged from 60 to 100 years (47.86%); married (26.64%); male (53.83%), of mixed ethnicity (20.97%), Catholic (6.51%), retired (23.11%), with elementary education (33.95%) and salary income ≤ 1 minimum wage (24.60%). There was a predominance of colostomy (83.95%), urgent (11.83%), without preoperative demarcation (4.22%), temporary permanence (42.69%), having the neoplasm as the cause main (51.14%), with complication of dermatitis (3.88%), diameter 20-40mm (1.69%), of 1 piece (16.15%), with pasty effluent (3.03%). The scarcity of Brazilian research on the subject is highlighted. However, it was possible to expand knowledge about the studied population.

How did COVID-19 measures impact sexual behaviour and access to HIV/STI services in Panama? Results from a national cross-sectional online survey

ObjectiveTo describe reported changes in sexual behaviours, including virtual sex (sexting and cybersex), and access to HIV/STI testing and care during COVID-19 measures in Panama.MethodsWe conducted an online cross-sectional survey from 8 August to 12 September 2020 among adults (≥18 years) residing in Panama. Participants were recruited through social media. Questions included demographics, access to HIV/STI testing and HIV care, and sexual behaviours 3 months before COVID-19 social distancing measures and during social distancing measures (COVID-19 measures). Logistic regression was used to identify associations between variables and behavioural changes.ResultsWe recruited 960 participants; 526 (54.8%) identified as cis-women, 366 (38.1%) cis-men and 68 (7.1%) non-binary or another gender. The median age was 28 years (IQR: 23–37 years), and 531 of 957 (55.5%) were of mixed ethnicity (mixed Indigenous/European/Afro-descendant ancestry). Before COVID-19 measures, virtual sex was reported by 38.5% (181 of 470) of cis-women, 58.4% (184 of 315) cis-men and 45.0% (27 of 60) non-binary participants. During COVID-19 measures, virtual sex increased among 17.2% of cis-women, 24.7% cis-men and 8.9% non-binary participants. During COVID-19 measures, 230 of 800 (28.8%) participants reported decreased casual sex compared with pre-COVID-19 measures. Compared with pre-COVID-19 measures, decreased casual sex was reported more frequently during COVID-19 measures by cis-men compared with cis-women (39.2% vs 22.9%, urban/rural adjusted OR (AOR)=2.17, 95% CI 1.57 to 3.01), and by Afro-descendant compared with participants of mixed ethnicity (40.0% vs 29.8%, AOR=1.78, 95% CI 1.07 to 2.94). Compared with no change in virtual sex (16.8%), increased virtual sex (38.5%, AOR=1.78, 95% CI 1.10 to 2.88) and decreased virtual sex (86.7%, AOR=16.53, 95% CI 7.74 to 35.27) were associated with decreased casual sex encounters. During COVID-19 measures, HIV/STI testing could not be obtained by 58.0% (58 of 100) of the participants who needed a test, and interrupted HIV care was reported by 53.3% (8 of 15) of participants living with HIV.ConclusionsCOVID-19 measures in Panama were associated with a decrease in casual sex among cis-men and Afro-descendant people, while access to HIV/STI testing and care was seriously disrupted.

Factors influencing wellbeing in young people during COVID-19.

COVID-19 infection and the resultant restrictions has impacted all aspects of life across the world. This study explores factors that promote or support wellbeing for young people during the pandemic, how they differ by age, using a self-reported online survey with those aged 8 - 25 in Wales between September 2020 and February 2021. Open-ended responses were analysed via thematic analysis to provide further context. A total of 6,291 responses were obtained from 81 education settings across Wales (including primary and secondary schools as well as sixth form, colleges and universities). Wellbeing was highest in primary school children and boys and lowest in those who were at secondary school children, who were girls and, those who preferred not to give a gender. Among primary school children, higher wellbeing was seen for those who played with others (rather than alone), were of Asian ethnicity (OR 2.3, 95% CI: 1.26 to 4.3), lived in a safe area (OR: 2.0, 95% CI: 1.67 to 2.5) and had more sleep. To support their wellbeing young people reported they would like to be able to play with their friends more. Among secondary school children those who were of mixed ethnicity reported lower wellbeing (OR: 5.10, 95% CI: 1.70 to 15.80). To support their wellbeing they reported they would like more support with mental health (due to anxiety and pressure to achieve when learning online). This study found self-reported wellbeing differed by gender, ethnicity and deprivation and found younger children report the need for play and to see friends to support wellbeing but older children/young people wanted more support with anxiety and educational pressures.

OP0096 EXPOSURE TO DENGUE INFECTION DO NOT RAISE RISK OF RHEUMATOID ARTHRITIS: FINDINGS FROM THE MALAYSIAN EPIDEMIOLOGICAL INVESTIGATION OF RHEUMATOID ARTHRITIS (MYEIRA) CASE-CONTROL STUDY

Background:Dengue infection is associated with joints pain mimicking disease onset symptom of rheumatoid arthritis (RA). However, there is lack of epidemiological studies on exposure to dengue infection and risk of future RA.Objectives:We investigated the relationship between exposure to dengue infection and risk of developing different subsets of RA, defined by the presence of anti-citrullinated peptide antibody (ACPA) in the multi-ethnic Malaysian population.Methods:Serum samples from 1,235 RA cases (i.e. 516 Malay, 254 Chinese, 405 Indians and 60 others/mixed-ethnicity) and 1,624 epidemiological matched population-based controls (i.e. 1,023 Malay, 208 Chinese, 297 Indians and 96 others/mixed-ethnicity) were assayed for presence of dengue IgG antibody using World Health Organization recommended ELISA kits. Positive results of dengue IgG antibodies indicates previous exposure to dengue infection(s). We performed chi-square and Mann-Whitney U analysis to determine the association of ever-exposed dengue infection with ACPA-positive/ACPA-negative RA and to investigate the antibody frequency and levels among the studied populations.Results:We observed high occurrence of dengue IgG antibody in the overall RA cases (79.7%) and matched controls (77.3%), with no significant differences detected between the ACPA subsets of RA. Ethnicity stratification analysis revealed a decrease risk of developing ACPA-positive RA in the Indian patients with positive dengue IgG antibody (OR=0.59, 95% CI=0.37-0.94, p=0.03), and in particular patients with elevated level of dengue IgG antibody (OR=0.44, 95% CI=0.25-0.78, p<0.05). On the other hand, the significant decrease mean levels of dengue IgG antibody were observed in the ACPA-positive RA subset for all three major ethnic groups (i.e. Malay, p<0.0001, Chinese, p<0.01 and Indian<0.05) (Figure 1). No association was observed between presence of dengue IgG antibody and ACPA-negative RA subset.Figure 1.Comparison of mean dengue IgG antibody level between ever-exposed dengue infection RA cases, stratified by ACPA status. Comparison of median dengue IgG antibody level between the ever-exposed dengue infection ACPA-positive RA and normal controls in the four ethnic groups. The red line indicates the mean level of dengue IgG antibody levelConclusion:Our findings demonstrated that exposure to dengue infection do not increase the risk of developing future RA in the multi-ethnic Malaysian population. The inverse associations observed in the Indian ethnic group are in line with the other studies investigating exposure to viral infection and risk of RA.References:[1]Sherina et al (2017) Low levels of antibodies against common viruses associate with anti-citrullinated protein antibody-positive rheumatoid arthritis; implications for disease aetiology. Arthritis Research & Therapy 2017, 19:2169[2]Gissel García et. al. (2011) Long-term persistence of clinical symptoms in dengue-infected persons and its association with immunological disorders. International Journal of Infectious Diseases 15 (2011) e38–e43Acknowledgements:The authors would like to thank the Director General of Health, Ministry of Health Malaysia for supporting this study. The authors are also indebted to participants for their kind participation. This study was financially supported by the Ministry of Health, Malaysia (JPP-IMR 17-025) and the short-term research grant by UniKL RCMP (str16037).Disclosure of Interests:None declared

May Measurement Month 2019: an analysis of blood pressure screening results from Mexico

May Measurement Month 2019 (MMM19) in Mexico was an opportunistic survey, aimed to improve blood pressure (BP) awareness at the individual and population levels. This survey followed the methodology of MMM19, previously published. The total number of participants screened was 39 700, 56.7% female, 36.6% were of mixed ethnicity, mean age [standard deviation (SD)] was 46.9 (17.4) years, and mean body mass index was 27.2 (SD: 4.4) kg/m2. Seven per cent of the participants reported having diabetes, 2.4% reported having a myocardial infarction in the past, 1.1% stroke, 2.0% were pregnant at the time of the survey, 3.7% of women had suffered from hypertension in a previous pregnancy, 11.4% declared that they were smokers, and 47.0% drank alcohol at least once a week. After multiple imputations, of all 39 700 participants, 10 140 (25.5%) had hypertension; of all participants with hypertension, 43.8% were aware of their diagnosis, 41.7% were on antihypertensive medication, and 27.8% had controlled BP (systolic BP &lt;140 mmHg and diastolic BP &lt;90 mmHg). Of those on antihypertensive medication, 27.8% had controlled BP. In Mexico, MMM is the largest hypertension survey ever done, it provides complementary data to the existing information on arterial hypertension in the country and helps to increase the visibility of hypertension: a priority health problem.

Variation in rates of self-harm hospital admission and re-admission by ethnicity in London: a population cohort study

Purpose To compare sex-specific rates of hospital admission and repeat admission following self-harm between ethnic groups in London and test whether differences persist after adjustment for socio-economic deprivation. Methods A population-based cohort of all individuals aged over 11 admitted to a general hospital for physical health treatment following self-harm between 2008 and 2018, using administrative Hospital Episode Statistics for all people living in Greater London. Results There were 59,510 individuals admitted to the hospital following self-harm in the 10 year study period, ethnicity data were available for 94% of individuals. The highest rates of self-harm admission and readmission were found in the White Irish group. Rates of admission and readmission were lower in Black and Asian people compared to White people for both sexes at all ages and in all more specific Black and Asian ethnic groups compared to White British. These differences increased with adjustment for socio-economic deprivation. People of Mixed ethnicity had higher rates of readmission. Rates were highest in the 25–49 age group for Black and Mixed ethnicity men, but in under-25 s for all other groups. There were substantial differences in rates within the broader ethnic categories, especially for the Black and White groups. Conclusion In contrast to earlier UK studies, self-harm rates were not higher in Black or South Asian women, with lower self-harm admission rates seen in almost all ethnic minority groups. Differences in rates by ethnicity were not explained by socio-economic deprivation. Aggregating ethnicity into broad categories masks important differences in self-harm rates between groups.