BackgroundStudies based on laboratory data about thyroid stimulating hormone (TSH) and free thyroxine (FT4) reference interval (RI) show conflicting results regarding the importance of using specific values by age groups with advancing age. Retrospective laboratory data or non-specific criteria in the selection of subjects to be studied may be factors leading to no clear conclusions. The aim of this study is to test the hypothesis that TSH and FT4 have specific RI for subjects over 60 to 80 years.MethodsWe evaluated prospectively 1200 subjects of both sexes stratified by age groups, initially submitted to a questionnaire to do the first selection to exclude those with factors that could interfere in TSH or FT4 levels. Then, we excluded those subjects with goiter or other abnormalities on physical examination, positive thyroid peroxidase antibodies (TPOAb), thyroglobulin antibodies (TGAb), and other laboratory abnormalities.ResultsTSH increased with age in the whole group. There was no statistical difference in the analysis of these independent subgroups: 20–49 versus 50–59 years old (p > 0.05), and 60–69 versus 70–79 years old (p > 0.05). Consequently, we achieved different TSH RI for the three major age groups, 20 to 59 years old: 0.4 - 4.3 mU/L, 60 to 79 years old: 0.4 - 5.8 mU/L and 80 years or more: 0.4 - 6.7 mU/L. Conversely, FT4 progressively decreases = significantly with age, but the independent comparison test between the sub-groups showed that after age 60 the same RI was obtained (0.7 - 1.7 ng/dL) although the minimum value was smaller than that defined by manufacturer. In the comparison between TSH data obtained by this study and those defined by the manufacturer (without segmentation by age) 6.5% of subjects between 60 and 79 years and 12.5% with 80 years or more would have a misdiagnosis of elevated TSH.ConclusionsTSH normal reference range increases with age, justifying the use of different RI in subjects 60 years old and over, while FT4 decreases with age. Using specific-age RI, a significant percentage of elderly will not be misdiagnosed as having subclinical hipothyroidism.

Issue and problem In Brazil, 47% of people are insufficiently physically active (Guthold et al, 2018). According to the Global Physical Activity Observatory, 13.2% of deaths in Brazil are caused by inactivity. Besides, Ding et al (2016) estimated the direct health cost attributable to physical inactivity in this country at 1.6 billion US dollars. Rio de Janeiro (RJ) is one of the largest cities in Brazil, with a high mortality rate (54.1%) from non-communicable diseases (NCDs) and substantial health inequalities (SIM/MRJ, 2019). As a large city, it reproduces a worldwide trend, which associates economic growth and urbanization with an unhealthy lifestyle and epidemic levels of obesity and remarkable physical inactivity (WHO, 2014). Problem description The multifactorial context above described enables NCDs and challenges health protection systems. For this reason, the Municipal Health Department of RJ implemented since 2009 a Health-Enhancing Physical Activity (HEPA) policy: ‘Programa Academia Carioca' (PAC). This policy supports regular physical activity free of charge, in Primary Care Health Units (UAP). The Program combines the practice of physical activity associated with various educational and community activities. It includes Physical Education professionals who work in a multidisciplinary way. Therefore, this study aims to evaluate the implementation of this policy. Results (effects/changes) After 11 years, the PAC has 142,969 participants, 80% of whom have NCDs. Among its participants, blood pressure control was demonstrated in 90% of hypertensive patients; weight loss, and a 60% reduction in cardiovascular risk classification, and suspension of medication in 20% of users. Being part of the PAC resulted in greater use and understanding of the general services of UAP in 86% and 98% of participants, respectively. Detailed results are not available at that time but will be presented at the conference. Lessons The PAC showed to be a successful tool to enhance health through physical activity at UAP. The use of trained and specialized professionals plays a fundamental key to develop educational and community actions in vulnerable groups. Main messages The implementation of an ambitious and integrated HEPA policy, considering environmental and health factors, can produce more effective institutional responses to change this epidemiological scenario.

Background and rationaleThe International Journal of Population Data Science (IJPDS) was launched in April 2017. It is an electronic, open-access, peer reviewed journal, publishing articles on all aspects of research, development and evaluation connected with about people and populations. It represents an internationally unique vehicle for publishing a broader range of articles than most journals in related fields by including in scope: working papers, methodological developments, informative reports, and other pieces of interest, in addition to more traditional manuscripts. As such, it provides a focal point (and a home) for all areas of Population Data Science. The creation of the IJPDS was inspired by the IPDLN, and places great importance on the viewpoints and activities of Network members to guide the development of the journal. ObjectiveInformation dissemination – stakeholder consultation – informing future directionsThe main objective of this collaborative session is to present the audience with an up-to-date summary of journal strategy and progress to date, and to use this forum to gain further viewpoints to better target future directions of the journal to meet the needs of those working in Population Data Science. PlanThe session will comprise 5 sections: A short presentation overviewing the journal, its historical origins, its remit and relationship to the IPDLN and Network members. Primary objectives of the journal and performance metrics from the first 18 months of operation will be presented. Gauging audience opinion on: What they like/dislike about the journal What is working well/not so well Feedback and discussion on the survey results Discussions with audience in groups, each focusing on some/all of the following questions, and a question of their own choice if something arises: How can we make IJPDS articles more accessible to the general reader/non-specialist researcher?Example options: short video/audio; general reader summaries; infographics; other How can we increase the reach of, and interest in, the journal? Open answers What would you suggest as a special issue?These topics for group discussion will be posed to the session audience with the aim of using the feedback in defining our priorities for the coming year. Feedback and summing up The groups will be asked to give their feedback. Feedback from the discussions and voting will be used to inform the next steps for IJPDS. Facilitators Kerina Jones, Founding Editor-in-Chief, Swansea University, Wales  Kim McGrail, Deputy Editor, University of British Columbia, Canada Claudia Medina Coeli, Editorial Board member, Rio de Janeiro Federal University, Brazil Rainer Schnell, Editorial Board member, University of Duisburg-Essen, Germany Stephanie Lee, Journal Director of Operations, Swansea University, Wales