bluuebunny/crossref_metadata_2025_split huggingface dataset:
1348Childhood adversities and diurnal patterns of salivary cortisol in adulthood: two UK-based prospective cohort studies
Authors: Akasaki Mifuyu , Hardy Rebecca , Steptoe Andrew 
Published: September 2021

Abstract

Background
Dysregulation of diurnal cortisol patterns may mediate between chronic stress and health problems. Findings on the association of childhood adversities with adult cortisol, however, are equivocal, mainly due to low statistical power, sample selection, and unstandardised indices of cortisol.

Methods
Participants were from Whitehall II study (n = 3434), and National Child Development Study (NCDS) (n = 2072). In Whitehall II, multilevel models were used to examine associations of retrospectively measured childhood adversities with two indices of diurnal cortisol patterns (awakening response and diurnal slope) at a median age of 65. In NCDS, regression was used to investigate associations of prospectively measured adversities with two measures of morning cortisol at the age of 44/45. We then regressed predicted values of cortisol from these models against count of adversities to examine dose-response effects.

Results
The prevalence of reporting at least one adversity was 67.8% in Whitehall II, and 47.8% in NCDS. None of the individual adversities were associated with overall cortisol levels in either study. However, for each additional adversity, there was a 1% elevated awakening response (95%CI: 0.8% to 1.19%), and, among men only, a 1.2% lower cortisol level at awakening (-1.98 to -0.40) with flatter diurnal slope (0.1 to 0.1) in Whitehall II; and a 1.3% lower cortisol level (-1.78 to -0.70) at 3.75 hrs after awakening in NCDS.

Conclusions
Experience of multiple childhood adversities may be associated with dysregulated salivary cortisol patterns later in life.

Key messages
Accumulation of childhood adversities might be associated with dysregulated diurnal cortisol patterns in adulthood.
785Excess mortality in severe mental disorders: a systematic review and meta-regression
Authors: Ali Miss Suhailah , Charlson Fiona 
Published: September 2021

Abstract

Background
Decades worth of epidemiological studies, synthesised by systematic reviews and meta-analyses, have consistently shown that people with severe mental disorders (SMD) have a higher risk of mortality compared to the general population, which has not improved over time. One of the major limitations of previous reviews is the use of meta-analytic models to synthesise mortality estimates without taking into account potential sources of heterogeneity.

Methods
A systematic review of studies examining mortality in people with schizophrenia and bipolar disorder compared to the general population was conducted. Estimates of all-cause and cause-specific mortality were calculated using meta-regression models to quantify and adjust for the effects of covariates, including both study-level and population-level factors.

Results
A total of 76 studies were included in the analyses. The adjusted relative risk for all-cause mortality in schizophrenia was 2.80 (95% CI 2.30 to 3.41) and 2.33 (95%CI 2.01 to 2.71) for bipolar disorder. Mortality was elevated in each cause of death examined, across both unnatural and natural causes. Some heterogeneity was explained by age and sex.

Conclusions
The mortality gap for people with SMD compared to the general population remains unchanged. Most of the heterogeneity between studies could not be accounted for by the covariates included in our analyses.

Key messages
More work needs to be done towards understanding the causal factors underlying excess mortality in people with SMD in order to achieve more equitable health outcomes.
827Early life influences on timing of menarche in racial/ethnic minority and immigrant women
Authors: April-Sanders Ayana , Tehranifar Parisa , Argov Erica Lee , Suglia Shakira , McDonald Jasmine 
Published: September 2021

Abstract

Background
Early life adversity and infections may theoretically affect the timing and effort of reproductive development. We examined associations of childhood adversity and exposure to tonsillitis with age at menarche in women age 40-64 years.

Methods
A multi-ethnic cohort of 394 women reported on exposure to parental maltreatment and maladjustment during childhood (&lt;18 years) and on any diagnosis of tonsillitis, an infection primarily acquired in early life and adolescence. We used linear and logistic regression models to examine the associations of cumulative/specific childhood adversity experience(s) and history of tonsillitis with average age at menarche and early onset of menarche (&lt;12 years of age).

Results
The average age at menarche was 12.6 years, and was significantly lower for women who lived with a mentally ill caregiver (M = 12.4 (95% CI: 11.7-13.0)) and those with a history of tonsillitis (M = 12.6 (95% CI: 12.0-13.2)). In adjusted multivariable models, living with a mentally ill caretaker (RR = 1.5, 95% CI: 1.0-2.1) and a having a history of tonsillitis (RR = 1.7, 95% CI: 1.3-2.4) were associated with increased risk of early menarche compared with women without these exposures. Cumulative and other specific adversities were not statistically associated with early menarche.

Conclusions
These findings support growing evidence that early life experiences may influence reproductive development.

Key messages
Early life adversity related to living with mentally ill caretakers and a history of tonsillitis is associated with earlier menarche in racial/ethnic minority and immigrant women.
40An antenatal care indicator based on contact with services and content developed for 63 countries
Authors: Arroyave Luisa , Saad-Haddad Ghada , Victora Cesar G , Barros Aluisio 
Published: September 2021

Abstract

Background
Most antenatal care (ANC) indicators in use are criticized for considering only contact with services and not taking into account content of care. We aimed to create and validate a new indicator measured as a score, considering both contact and content, that can be used for monitoring.

Methods
We used data from national surveys conducted in low and middle-income countries (LMICs). Information on ANC was used to build an adequacy score (ANCq) that would be applicable to all women in need of ANC. We used a convergent validation approach, exploring the association of our proposed indicator with neonatal mortality.

Results
The ANCq score was derived from seven variables related to contact with services and content of care ranging from zero to ten. Surveys from 63 countries with all variables were used. The overall mean of ANCq was 6.7, ranging from 3.5 in Afghanistan to 9.3 in Cuba and the Dominican Republic. In most countries, the ANCq was inversely associated with neonatal mortality and the pooled for all surveys Odds Ratio was 0.90 (95% CI = 0.88-0.92).

Conclusions
The ANCq presented good validity properties, being a useful tool for assessing ANC coverage and adequacy of care in monitoring and accountability exercises.

Key messages
ANCq provides a standardized and comparable measure of ANC adequacy, allowing for comparisons between country population subgroups and between countries.
590Online + In-person: A Model for the Instruction of Contemporary Epidemiologic Methods in Resource-Limited Settings
Authors: Avelino-silva Vivian , Semeere Aggrey , Laker-Oketta Miriam , Byakwaga Helen , Pletcher Mark , Martin Jeffrey 
Published: September 2021

Abstract

Focus of Presentation
Many low-income countries cannot support faculty to develop contemporary graduate-level courses in epidemiology and biostatistics. There are also insufficient resources to support all students who are interested in traveling abroad to study in resource-rich settings. To address this, we describe our experience with training a few students from resource-limited countries in the U.S. who have subsequently returned to their home countries and became instructors in a novel online plus in-person teaching model.

Findings
Most courses at our major U.S. training program in epidemiology videotape lectures for viewing on one’s own and post all other materials (e.g., homework) on the course’s website. The weekly learning cycle culminates with an in-person high-level small group discussion, led by a faculty member who facilitates 10-15 students. For the past 5 years, non-U.S. scholars from Africa and South America who have taken our courses in the U.S. have travelled back to their countries and become small group leaders for our courses. Identical to U.S. students, the students in these international venues view videotaped lectures, access other materials online, and have weekly in-person small group discussions. These international students represent another concurrent small group for the U.S-based course; they have identical access and evaluation.

Conclusions
By pairing online resources from a resource-rich setting with local in-person instruction, we provide students in resource-limited settings access to contemporary instruction in epidemiology at very low cost.

Key messages
Online plus local in-person teaching is a feasible model for providing instruction regarding epidemiologic methods in resource-limited settings.
1377Did patient blood management guidelines reduce the rate of blood transfusion in pregnancy?
Authors: Baldwin Heather , Randall Deborah , Nippita Tanya , Torvaldsen Siranda , Patterson Jillian 
Published: September 2021

Abstract

Background
Concern about increasing transfusion rates, adverse effects and increased costs have led to international efforts to reduce transfusion rates. Australian patient blood management guidelines were first introduced for critical bleeding in 2011, followed by obstetric guidelines in 2015. This study examines obstetric transfusion rates before and after the introduction of the critical bleeding and obstetric guidelines, accounting for pregnancy characteristics and prior trajectories.

Methods
Data were obtained from linked birth and hospital records from NSW between January 2002 and December 2017. Changes in raw and risk adjusted transfusion rates over time were investigated using interrupted time series analysis to assess changes in the trend in rate of transfusion among pregnant women with the introduction of each set of guidelines. Sensitivity analysis was performed to identify patterns in the data independently from the interventions.

Results
Data for 1,477,001 births in NSW from 2002 to 2017 were available for analysis. Preliminary analysis suggests the increasing rate of transfusion from 2002 was flattened after the introduction of the 2011 guidelines, with a significantly decreasing trend observed after the 2015 obstetric guidelines were introduced.

Conclusions
Patient blood management guidelines were associated with a reduction in the rate of obstetric transfusion in NSW.

Key messages
A focus on patient blood management was associated with an approximately 30% reduction in the transfusion rate, compared to the predicted rate, by the end of the study period. Future work will investigate whether this change in transfusion rates is associated with a change in rates of adverse outcomes.
1000Quantifying multiple causes of death: A systematic review and audit of methods and practice
Authors: Balogun Saliu , Bishop Karen , Eynstone-Hinkins James , Martin Melonie , Moreno-Betancur Margarita , Rao Chalapati , Joshy Grace 
Published: September 2021

Abstract

Background
Mortality reporting and research are typically focused on a single underlying cause of death (UCoD) selected from multiple reported causes. The need to incorporate multiple causes of death (MCoD) in mortality statistics is now recognised internationally, but there is scant methodological work to guide analytical approaches. This review aims to identify and appraise current methods and practices used to analyse MCoD data.

Methods
The Web of Science, Medline, Pubmed and Scopus (from inception to December 2019) were queried. Studies reporting MCoD alone or in comparison with single UCoD were included. The review is supplemented by qualitative interview with international experts.

Results
3491 studies were identified; 141 full texts were included in the review. The measures usually estimated when analysing MCoD can be broadly categorised into descriptive measures (n = 93 studies), measures of associations between diseases (n = 46 studies) and advanced statistical methods (n = 11 studies). Descriptive statistics commonly used include standardized ratio of multiple to underlying cause (SRMU) and mortality rates based on any mention of a disease. Approaches used to assess measures of associations between diseases include the Cause-of-Death Association Indicator (CDAI) and social network analysis. The advanced statistical methods include weighting MCoD and lethal defect-wear model of mortality. Audit results will be discussed.

Conclusions
This review provides a comprehensive and updated summary of methodological approaches used to analyse MCoD data. The merit of each analytical framework is discussed.

Key messages
More work is needed to develop methodological frameworks that could be used to support routine consideration of MCoD in practice.
934Prevalence by proxy: Estimating youth smoking prevalence using nationally representative household surveys
Authors: Barrett Eden , Marmor Alexandra , Maddox Raglan , Thandrayen Joanne , Johnson Fiona , Banks Emily , Lovett Raymond , Thurber Katherine 
Published: September 2021

Abstract

Background
Reducing youth (15-17 years) smoking uptake is critical to tobacco control; accordingly, youth smoking prevalence is a key monitoring and evaluation outcome. Many nationally representative surveys collect youth smoking behaviour data from, or in the presence of, the youth’s parent or caregiver. We aimed to quantify the potential bias conferred by this.

Methods
We compared youth smoking prevalence when reported by parent proxy, with parent present or by private self-report, in Australian Bureau of Statistics Health Surveys. National youth current smoking prevalence if all data were collected by youth self-report was estimated.

Results
Smoking behaviour data for over 75% of youth participants in the health survey were collected by proxy or with parent present. Ever-smoking prevalence using private self-report versus report by proxy was 1.29 (95%CI:0.96-1.73) to 1.99 (1.39-2.85) times as high in Aboriginal and Torres Strait Islander youth, and 1.83 (0.92-2.63) to 2.72 (1.68-4.41) times as high in total population youth. Predicted national current smoking prevalence if all youth were to self-report alone was substantively higher than the estimated national prevalence based on actual responses, but still reveals a decline over time.

Conclusions
Youth smoking estimates drawn from data collected by proxy/with parent present are unlikely to be accurate. Increased youth self-report is crucial to ensure data accuracy to inform effective tobacco control.

Key messages
The accuracy of youth smoking data collected by proxy/with parent present should be further scrutinised before it is used to inform assessment of national prevalence and trends.
1527Effect of a text-messaging intervention on oral self-care practices in antenatal women in Delhi, India
Authors: Basu Saurav , Rajeev Anjali , Garg Suneela , Singh Mongjam 
Published: September 2021

Abstract

Objective
to determine the effect of a mHealth (text-message) intervention compared with a structured health educational session on the oral care and hygiene practices of pregnant women.

Methods
We conducted a pilot Randomized Control Trial parallel design superiority trial with a 1:1 allocation ratio. A total of 76 pregnant women up-to 20 weeks of gestational age and capable of reading mobile phone text-messages were recruited during August-October’ 2020 from the antenatal clinic of a primary health centre in a low-income urban agglomeration in Delhi, India. The mHealth intervention arm participants were sent a daily text-message for 30 days while all participants were provided a face-face, brief didactic structured educational sessions towards oral health promotion.

Results
The baseline characteristics of both groups were comparable in terms of age-structure, education, parity, and oral hygiene but differed in terms of oral health problems. Post-intervention, although, the twice-brushing frequency increased in both arms, only the mHealth arm revealed a statistically significant reduction in the incidence of missed twice daily brushing episodes (p = 0.016). The absolute effect size for the primary outcome signifying the difference in the proportion of participants reporting twice daily brushing frequency habit between the mHealth and comparison arms’ was 0.090, the Cohen’s H was 0.182, and the odds of twice brushing habit in the mHealth arm was 1.44 times higher than in the comparison arm.

Conclusions
a mHealth based daily text-message intervention for one month was not superior to a one-time brief didactic structured educational intervention for oral health promotion in antenatal women.

Keywords
mHealth; Dental health promotion; Dental health education; Antenatal care
1498Community-level risk factors for birth size of child in selected developing countries (1992-2018): multilevel analysis
Authors: Bawankule Rahul , Singh Abhishek 
Published: September 2021

Abstract

Background
We aimed to identify emerging community-level risk factors for birth size in the last two decades in developing countries, particularly in Bangladesh, India, Indonesia, and Nigeria, having the highest burden of low birth weight (LBW) births globally.

Methods
We used data from multiple rounds of the Demographic and Health Surveys (DHS) conducted throughout the last two decades in the selected countries. We applied multilevel binary logistic regression models and estimated the intra-correlation coefficient (ICC) and median odds ratio (MOR) with a 95% confidence interval (CI) to analyze community-level variation in the birth size of child.

Results
The odds of having a smaller than average size birth increased by 1.28 times (95% CI: 1.11-1.79) in Bangladesh (2014), 3.03 times (95% CI: 2.90-3.18) in India (2015-16), 1.40 times (95% CI: 1.28-1.58) in Indonesia (2017) and 2.32 times (95% CI: 2.15-2.53) in Nigeria (2018) when women moved from low-risk to high-risk communities. The children residing in communities with a higher level of female illiteracy, higher level of inadequate antenatal care visits (ANC), higher use of unimproved toilet facilities were more likely to born with smaller than average birth size during 1992-2018.

Conclusions
The study confirms a significant community-level variation in smaller than average birth size among all analysed countries. Community with higher levels of female illiteracy, inadequate ANC visits, use of unimproved toilet facilities emerged as significant risk factors throughout the last two decades.

Key messages
The community-level risk factors have an independent association with the birth size of child regardless of individual-level characteristics of women and children.
939Longitudinal trends of work productivity in a representative sample of Australians living with multiple sclerosis
Authors: Bessing Barnabas , Blizzard Leigh , Hussain Mohammad A. , Claflin Suzi B. , Taylor Bruce V. , Mei Assoc Ingrid van der 
Published: September 2021

Abstract

Background
studies have documented increased employment rates and MS-related work productivity loss in people living with multiple sclerosis (PwMS). Little is known about the longitudinal trends of work productivity of PwMS.

Objectives
To describe the longitudinal patterns of work productivity of PwMS, and examine the factors associated with longitudinal change of work productivity of PwMS.

Methods
Study participants were from the Australian MS Longitudinal Study (AMSLS) followed from 2015 to 2018 (n = 2724) who were employed. We described the longitudinal patterns of work productivity and determined the correlates of the changes in work productivity of PwMS. We used linear mixed effect modelling to analyse the data.

Results
From our mixed effect model analysis, feelings of depression, walking difficulties, and spasticity problems were independently associated with -1.45 (-1.95 to -0.95), -1.35 (-1.98 to -0.72) and -1.04 (-1.63 to -0.45) per annum change in work productivity respectively. Annual changes in MS symptom clusters: difficulties with walking, balance and spasticity; anxiety and depression; and fatigue and cognitive symptoms were independently associated with -2.53 (-3.53 to -1.52), -1.51 (-2.27 to -0.74), -0.86 (-1.67 to -0.06) percent annual change in work productivity of PwMS respectively.

Conclusion
Symptoms cluster like ‘difficulties with walking, balance and spasticity’, ‘feelings of anxiety and depression’, and ‘fatigue and cognitive symptoms’ impact significantly on work productivity.

Key messages
MS related annual work productivity loss is marginal but is strongly driven by annual changes in walking difficulties, feelings of depression and spasticity problems
1324Clinical Registry for Acute Respiratory Infections in Children in Western Australia
Authors: Bhuiyan Mejbah , Pavlos Rebecca , O'Brien Sharon , Borland Meredith , Doyle Sarah , Blyth Christopher 
Published: September 2021

Abstract

Background
Acute respiratory infections (ARIs) are the leading cause for emergency presentation and a major driver for antibiotic use in children. In 2020, we established an ARI clinical registry to: evaluate clinical care for ARI to inform clinical guidelines; and as a platform for clinical trials assessing antimicrobial interventions.

Methods
Any child &lt;16 years presenting to Perth Children’s Hospital Emergency Department (ED) with cough, fever, sore throat and/or difficulty breathing was eligible for enrolment. Using an automated survey sent to parents’ mobile phones, each enrolled child was followed weekly until 28 days or disease recovery (whichever occurred first). Data collected included clinical symptoms, antibiotic prescription, adherence, and duration to return to regular activity (recovery).

Results
From Feb 2020-April 2021, 448 participants were enrolled (84% &lt;5 years). Fever and cough were the most frequently reported symptoms. Of 448, 274 (61%) ARI cases completed all surveys until recovered. The median recovery length was 9 days (IQR:6-12). The recovery days were longer, although not statistically significant (p &gt; 0.05), in: children who received antibiotics versus those who did not (9.5 days vs. 8); children &lt;5 years versus those over (9 days vs. 7); and children with chronic illnesses versus those without (9 days vs. 8).

Conclusions
Most children presenting to ED with ARI recover within 10 days. The length of recovery does not vary significantly by age, chronic illnesses, or antibiotic usage.

Key messages
Registry data provides baseline data to inform clinical trials assessing the role and duration of antibiotics for ARI.