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Is occupational exposure to radiofrequency electromagnetic fields associated with glioma risk? An Australian population-based family case-control study

Por: Mate · R. · Benke · G. · Loughran · S. P. · Abramson · M. J. · Vjadic · C. · Turner · M. · Turuban · M. · Cardis · E. · Karipidis · K.
Objectives

This study investigated occupational exposure to radiofrequency electromagnetic fields (RF EMF) using two job-exposure matrices (JEMs) and risk of glioma.

Design

Population-based family case–control study.

Setting

Cases were recruited from participating hospitals in the Australian states of New South Wales, Queensland, Tasmania, Western Australia and Victoria between January 2013 and November 2017.

Participants

The study population consisted of 467 cases of glioma and 367 family controls recruited for the Australian Genomics and Clinical Outcomes of Glioma case–control study between 2013 and 2017. Participants completed questionnaires on demographic and other information, including a detailed occupational history.

Exposures

Exposure to RF EMF was estimated using both the multicountry case–control study INTEROCC JEM and the Canadian JEM (CANJEM).

Primary outcome measures

ORs and 95% CIs were calculated from logistic regression models adjusted for relatedness between cases and controls, sex, age, ethnicity, education level, smoking status and alcohol consumption.

Results

There was no statistically significant positive association overall for risk of glioma when applying either JEM. For the highest compared with the lowest quartile of lifetime exposure, results using the INTEROCC JEM showed an OR of 0.74 (95% CI 0.47 to 1.15) for electric fields and 0.92 (95% CI 0.58 to 1.45) for magnetic fields, while the CANJEM showed an OR of 0.85 (95% CI 0.54 to 1.32). We also did not observe associations when applying different assumptions regarding latency or time windows or with glioma grade.

Conclusion

Overall, this study found no evidence of an association between occupational RF EMF exposure and glioma. Future research should focus on refining occupational RF EMF exposure assessment.

Using real-world evidence to evaluate the long-term health and economic impact of the digital tool Grohealth W8Buddy supporting access to specialist weight management services: a protocol for a cohort observational study

Por: Deo · P. S. · Grove · A. · Zhang · M. · Abrams · K. R. · Auguste · P. · Barber · T. M. · Gazeley · T. · Green · R. · Griffiths · F. · Hazlehurst · J. · Hee · S. W. · Kaura · A. · Mallipedhi · A. · OToole · S. · Panesar · A. · Parsons · N. · Scott · E. · Summers · C. · Thind · M. · Thorpe · M.
Introduction

Obesity affects over a quarter of the UK population and can lead to serious health issues. NHS Specialist Weight Management Services (WMS) offer treatments including lifestyle advice, psychological support and medications, but access and availability vary by region. Although around 4 million people could be eligible for NHS Specialist WMS annually, capacity is limited to 35 000, severely limiting overall access for those who need it. While digital technology has started to be used in WMS, more evidence is needed to confirm its long-term effectiveness, acceptability and cost-effectiveness. This study explores the use of Gro Health W8Buddy, a digital platform and app providing remote Specialist WMS. It aims to determine the long-term health benefits of remote WMS pathway Gro Health W8Buddy compared with standard NHS WMS delivered in hospitals, and to improve patients access to services.

Methods and analysis

The study is a real-world evaluation with observational data collection. We will recruit 450 study participants from four NHS specialist WMS who will choose either standard NHS WMS or the digital pathway Gro Health W8Buddy. Participants are being given the option to choose their pathway to generate real-world evidence. We will measure and analyse health outcomes including weight loss, time taken to be treated and cost-effectiveness, at 18 months and follow up at 24 months for later analysis (outside of this core funding). We will gather experiential data from patients and healthcare professionals through surveys, observation and interviews.

Ethics and dissemination

Ethical approval has been obtained from NHS Health Research Authority (HRA) and Health and Care Research Wales (HCRW) (Supplementary Figure 3) (REC reference: 25/EM/0147). Our findings will be disseminated through academic publications, conference presentations and stakeholder engagement.

Trial registration

ISRCTN89168871; Pre-results.

Examining differences in clinical and demographic characteristics of patients with post-traumatic stress disorder across adult treatment subgroups based on the NeuroBlu database: a non-interventional, retrospective cohort study

Por: Abramsky · S. · St.Rose · S. · Heng · Y. W. · Vance · L. A. · Zhang · L. · Chan · K. M. · Wong · J. G. · Kuah · S. · Low · L. T. · Adamczyk · I.
Background

Post-traumatic stress disorder (PTSD) is a heterogeneous psychiatric disorder, with symptom variation between patients.

Objective

We describe clinical and demographic characteristics of patients with PTSD based on real-world data.

Methods

This non-interventional, retrospective cohort study analysed de-identified electronic health records of patients from the Holmusk NeuroBlu database in the USA. Patients with ≥2 PTSD diagnoses captured in the database within 30 days between 2001 and 2020 were included. The index date was defined as the date of the first recorded PTSD diagnosis. In patients who were aged ≥18 years, demographic and clinical characteristics at baseline (index date ±14 days), in the 6 months prior to baseline and 12 months after baseline were described. Patients were stratified into four mutually exclusive subgroups according to treatment received: psychotherapy only, pharmacotherapy only, psychotherapy and pharmacotherapy, and untreated. Natural language processing models were used to derive PTSD symptoms from unstructured clinician-documented mental state examination data. Data were analysed descriptively.

Findings

A total of 37,449 patients had ≥2 PTSD diagnoses within 30 days between 2001 and 2020; 32,875 patients received care at clinical sites with both inpatient/outpatient units; 25,507 patients received psychotherapy and/or pharmacotherapy as per further prespecified criteria, and 17,234 were ≥18 years old and included in this analysis. Most patients (84.9%) received psychotherapy, pharmacotherapy or both during the first year post-baseline. Mean age (SD) was 37.7 (12.4) years, 73.4% of patients were female and 59.6% were White. At baseline, 98% of patients had ≥1 psychiatric comorbidity; major depressive disorder (42.2%), substance use disorder (35%) and anxiety disorder (30.7%) were most frequently reported. Reported suicidal ideation/attempts were most frequent in the pharmacotherapy only group compared with other subgroups at baseline. The most frequently prescribed drug classes were antidepressants (51.8%), second-generation antipsychotics (29.9%) and anxiolytics (23.3%) at baseline. Trazodone, clonazepam, quetiapine and sertraline were the most frequently prescribed medications.

Conclusion

In the overall study population, most patients were female, with a high prevalence of psychiatric comorbidities. Demographic and clinical characteristics observed in this study varied across treatment subgroups. These insights may support patient-specific treatment planning and inform health-economic decision models in PTSD.

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