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Xiong W, Wang B, Han F, Tong J, Gao H, Ding P, Liu K, Wu X, Huang K, Geng M, Tao F. Association between maternal antibiotic exposure and emotional and behavioural problems in children at four years of age: A biomonitoring-based prospective study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 284:116949. [PMID: 39208579 DOI: 10.1016/j.ecoenv.2024.116949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 08/24/2024] [Accepted: 08/24/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Maternal exposure to multiple antibiotics exposure during pregnancy has attracted extensive attention, but biomonitoring studies linking prenatal antibiotic exposure to emotional and behavioural problems in children are limited. METHODS A total of 2475 pregnant women from the Ma'anshan Birth Cohort were included, and the Strengths and Difficulties Questionnaire was completed when their children turned four years of age. The levels of 41 maternal urinary antibiotics and two metabolites were measured during the first, second and third trimesters. Generalized estimating equations and binary logistic regression models were applied to analyse the associations between maternal antibiotic exposure and emotional and behavioural problems in children and to determine the sensitive period, respectively. A quantile-based g-computation (QGC) approach was employed to examine the combined effects of multiple antibiotics on emotional and behavioural problems in children. RESULTS Overall, florfenicol and preferred-as-veterinary antibiotic (PVA) exposure during pregnancy increased the risk of emotional problems in children, and ofloxacin exposure increased the risk of hyperactivity-inattention. Maternal exposure to trimethoprime, ciprofloxacin, florfenicol, other antibiotics and PVA exposure during the first trimester was positively associated with emotional problems in children. Second-trimester trimethoprime concentrations and third-trimester ciprofloxacin concentrations were positively associated with hyperactivity-inattention. Third-trimester veterinary antibiotic (VA) exposure was negatively associated with hyperactivity-inattention, and second-trimester VA and PVA exposure was negatively associated with peer problems. The QGC model revealed that mixed antibiotic exposure in the first trimester exacerbated the risk of childhood emotional problems (the contribution of ciprofloxacin is prominent), and mixed antibiotic exposure in the second trimester increased the risk of hyperactivity-inattention (the contribution of trimethoprime is prominent). CONCLUSION Maternal mixed antibiotic exposure during the first and second trimesters increases the risk of emotional problems and hyperactivity-inattention in children at four years of age.
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Affiliation(s)
- Wanhong Xiong
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China
| | - Baolin Wang
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China
| | - Feifei Han
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China
| | - Juan Tong
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, Anhui 230032, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, Anhui 230032, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China; Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China
| | - Hui Gao
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, Anhui 230032, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China; Department of Pediatric, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, Anhui 230022, China
| | - Peng Ding
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, Anhui 230032, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, Anhui 230032, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China; Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China
| | - Kaiyong Liu
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, Anhui 230032, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China
| | - Xiaoyan Wu
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, Anhui 230032, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, Anhui 230032, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China
| | - Kun Huang
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, Anhui 230032, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, Anhui 230032, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China
| | - Menglong Geng
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, Anhui 230032, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, Anhui 230032, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China; Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China.
| | - Fangbiao Tao
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, Anhui 230032, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, Anhui 230032, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China.
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Gültekin MZ, Doğar F, Sarı AS, Coşkun F, Yıldırım A. The role of the psychological attributes of parents and children, and fracture history in upper extremity fractures in school-age and adolescents: A case-control study. Jt Dis Relat Surg 2024; 35:315-323. [PMID: 38727110 PMCID: PMC11128968 DOI: 10.52312/jdrs.2023.1486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/16/2023] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVES This study aims to investigate the influence of parents and children's psychological attributes and previous fracture history on upper extremity fractures in school-aged and adolescent children. PATIENTS AND METHODS Between January 2022 and January 2023, a total of 194 participants consisting of 97 cases with upper extremity fractures (23 males, 74 females; median age: 10 years; range, 6 to 16 years) and 97 age-matched controls suffering from growing pains (47 males, 50 females; median age: 10 years; range, 6 to 16 years) were included in this case-control study. Both cases and controls were of school-age or over. The parents of the children were interviewed face-to-face using psychological scales including the Adult Attention Deficit Hyperactivity Disorder Self-Report Scale (ASRS), the Autism-Spectrum Quotient (AQ), the Short Form of the Conners' Parent Rating Scale-Revised (CPRS-R:S), and the Developmental Coordination Disorder Questionnaire 2007 (DCDQ'07). The results derived from these scales and the demographics of the participants were evaluated in terms of their association with the risk of upper extremity fractures. RESULTS A household income below the official minimum monthly wage (MMW) and a previous fracture history showed a higher risk for upper extremity fractures (odds ratio [OR]=2.38, 95% confidence interval [CI]: 1.07-5.26 and OR=24.93, 95% CI: 3.27-189.98, respectively). In the univariate analyses, elevated scores on the hyperactivity subscale of CPRS-R:S (CPRS-R:SHS) were associated with a higher fracture risk (OR=1.14, 95% CI: 1.05-1.24). Furthermore, both a household income below MMW, a previous fracture history, and higher CPRS-R:S-HS scores were found as independent risk factors for upper extremity fractures in the multivariate regression analysis (OR=2.78, 95% CI: 1.13-6.86, OR=21.79, 95% CI: 2.73-174.03), and OR=1.11, 95% CI: 1.02-1.22, respectively). CONCLUSION Our study results highlight the importance of known risk factors for upper extremity fractures such as lower monthly wage and the presence of previous fractures. The psychological states of parents and children should be evaluated together.
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Sarfo JO, Amoadu M, Obeng P, Kordorwu PY, Adams AK, Gyan TB, Osman AG, Asiedu I. Prevalence and factors associated with serious injuries and aggressive behaviours among in-school adolescents in Panama. DIALOGUES IN HEALTH 2023; 2:100103. [PMID: 38515484 PMCID: PMC10953970 DOI: 10.1016/j.dialog.2023.100103] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 12/28/2022] [Accepted: 01/15/2023] [Indexed: 03/23/2024]
Abstract
Introduction Injuries during adolescence cause lifelong harm and death. Our study used a nationally representative sample to examine the prevalence and risk factors associated with serious injuries among in-school adolescents in Panama. Methods We analysed Panama's 2018 Global School-Based Student Health Survey data using SPSS. Percentages were used to summarise the results of the prevalence of serious injuries. Binomial logistic regression analysis was performed to examine the risk factors of serious injuries. The results were presented as an adjusted odds ratio (AOR) at a 95% confidence interval (CI). Results The prevalence of serious injury among in-school adolescents in Panama is 45%. Furthermore, the study found that males (AOR= 1.495, CI=1.272--1.756), truancy (AOR=1.493, CI=1.249--1.785), overweight (AOR= 1.246, 95% CI=11.057--1.469), drinking alcohol (AOR= 1.397, CI=1.151--1.695), experiencing physical attack (AOR= 2.100, CI=11.646--2.681), engaging in a physical fight (AOR=1.586, CI=1.289--1.952) and bullied outside school (AOR=1.276, CI=1.005--1.621) significantly predict serious injuries among adolescents in Panama. Conclusion Multidisciplinary approaches targeting the correlates observed will help reduce the high prevalence of serious injuries among in-school adolescents in Panama.
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Affiliation(s)
| | | | - Paul Obeng
- University of Cape Coast, Cape Coast, Ghana
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Sarfo JO, Obeng P, Gbordzoe NI, Debrah TP, Ofori COB, Hagan JE. In-school adolescents' sociodemographic correlates of serious unintentional injuries in Saint Vincent and the Grenadines: A cross-sectional study. Health Sci Rep 2023; 6:e1722. [PMID: 38028691 PMCID: PMC10667840 DOI: 10.1002/hsr2.1722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 07/04/2023] [Accepted: 11/02/2023] [Indexed: 12/01/2023] Open
Abstract
Background As a public health concern, serious adolescent injuries constitute considerable global morbidity and mortality. Despite the proliferation of literature on this problem, the evidence on the determinants of injuries among in-school adolescents in Saint Vincent and the Grenadines (SVG) is insufficient. Method The study analyzed data from the 2018 Global School-based Student Health Survey to examine the prevalence and determinants of serious injuries in a nationwide adolescent sample in SVG. χ 2 And binomial logistic regression analyses were carried out, along with an adjusted odds ratio and a 95% confidence interval. Results Serious injuries among this population were estimated at 50.5%. Student grades, gender, truancy, amphetamine or methamphetamine use, marijuana or alcohol use, cigarette smoking, physical assault, physical fight, cyberbullying, suicidal behavior (ideation, plan, and attempt), parental or guardian tobacco use, and multiple sexual partners were significantly associated with serious injuries. After adjusting for other variables, being a male, having experienced a physical attack, fighting physically, attempting suicide, and having multiple sexual partners predicted serious injuries among in-school adolescents in SVG. Conclusion The use of integrative health promotion and injury prevention programmes (e.g., antiviolence campaigns) and educational measures could help minimize or eradicate this menace in SVG.
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Affiliation(s)
- Jacob O. Sarfo
- Department of Health, Physical Education and RecreationUniversity of Cape CoastCape CoastGhana
| | - Paul Obeng
- Department of Health, Physical Education and RecreationUniversity of Cape CoastCape CoastGhana
| | | | - Timothy P. Debrah
- Department of NursingKwame Nkrumah University of Science and TechnologyKumasiGhana
| | | | - John E. Hagan
- Department of Health, Physical Education and RecreationUniversity of Cape CoastCape CoastGhana
- Neurocognition and Action‐Biomechanics‐Research Group, Faculty of Psychology and Sports ScienceBielefeld UniversityBielefeldGermany
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Abio A, Ngum P, Lowery Wilson M, Bärnighausen T, Lule H. Sociodemographic distribution and correlates of nonfatal unintentional non-traffic-related injuries in Kenya: Results from the 2014 demographic and health survey. Health Sci Rep 2023; 6:e1323. [PMID: 37292100 PMCID: PMC10246455 DOI: 10.1002/hsr2.1323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/24/2023] [Accepted: 05/24/2023] [Indexed: 06/10/2023] Open
Abstract
Background and Aim Injuries are among the leading causes of mortality worldwide. There exists a paucity of nationally representative injury data from the sub-Saharan African region on the nature of injuries outside of road traffic contexts. The aim of this study was to estimate the prevalence of nonfatal unintentional injuries that occurred outside of the traffic environment among persons aged 15-54 years in Kenya. Methods We used the 2014 Kenyan Demographic Health Survey data to estimate the prevalence of nonfatal unintentional injuries and their injury mechanisms. Binary logistic regression was used to estimate the odds of unintentional injuries and associated factors. Results Injury prevalence was three times higher among males (27.56%) compared to females (8.25%). The highest prevalence for females and males respectively was among those aged 15-19 years (9.80%) and (31.18%), rural residents (8.45%) and (30.05%) and those who consumed alcohol (18.13%), and (31.39%). For both females and males, the most frequent injuries were cuts (4.95%; 18.15%) and as result of falls (3.29%; 8.92%) respectively. Burns were more prevalent among females (1.65%) compared to males (0.76%). Among males, the demographic and contextual factors associated with nontraffic unintentional injuries were residing in a rural area (OR 1.33, 95% CI 1.14, 1.56), primary education (OR 2.02, 95% CI 1.48, 2.76), a higher wealth index (second quintile OR 1.41, 95% CI 1.19, 1.67) and consuming alcohol (OR 1.49, 95% CI 1.32, 1.69). Females who had completed primary, secondary (OR 2.43, 95% CI 1.92, 3.08) or higher education had higher odds of unintentional injuries. Conclusion The findings mirror prior literature highlighting the clustering of demographic and behavioral factors which underlie predisposition to injuries outside of the traffic environment. Future nationally representative studies would benefit from deeper inquiry into and measurement of injury severity and health care utilization to inform strategic policy-relevant research.
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Affiliation(s)
- Anne Abio
- Department of Clinical NeurosciencesInjury Epidemiology and Prevention (IEP) Research Group, Turku Brain Injury Centre, Turku University Hospital, University of TurkuTurkuFinland
- Heidelberg Institute of Global Health (HIGH), University Hospital and University of HeidelbergHeidelbergGermany
| | - Peter Ngum
- Department of NeurologyTurku Brain Injury Center, Turku University Hospital, University of TurkuTurkuFinland
| | - Michael Lowery Wilson
- Heidelberg Institute of Global Health (HIGH), University Hospital and University of HeidelbergHeidelbergGermany
| | - Till Bärnighausen
- Heidelberg Institute of Global Health (HIGH), University Hospital and University of HeidelbergHeidelbergGermany
| | - Herman Lule
- Department of Clinical NeurosciencesInjury Epidemiology and Prevention (IEP) Research Group, Turku Brain Injury Centre, Turku University Hospital, University of TurkuTurkuFinland
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Stehr P, Reifegerste D, Rossmann C, Caspar K, Schulze A, Lindemann AK. Effective communication with caregivers to prevent unintentional injuries in children under seven years. A systematic review. PATIENT EDUCATION AND COUNSELING 2022; 105:2721-2730. [PMID: 35537900 DOI: 10.1016/j.pec.2022.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 04/22/2022] [Accepted: 04/25/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE This review systematically examines the theory base and effectiveness of communication strategies (i.e., message content, message attributes, communication channels, and communicators) of interventions for caregivers to prevent unintentional child injuries. METHODS Relevant articles were searched in the databases Communication and Mass Media Complete, PsycInfo, Pubmed, and Google Scholar, the journal Injury Prevention, and the literature of included studies. A total of 71 articles reporting 67 different studies were included and fully coded. Quality was assessed using the Mixed Methods Appraisal Tool. Coded categories and their frequencies are described, and the effectiveness of different communication strategies is explored with crosstabs. RESULTS Only 17 studies stated the use of a specific theory base; Precaution Adoption Process-Model, Theory of Planned Behavior, and Health Belief Model were most often used. The message content of most studies aimed at knowledge dissemination; however, addressing behavioral determinants, such as risk perception and self-efficacy, was more effective. About half of the studies did not elaborate on message attributes; calls to action, exemplars, and tailoring were most often used, the latter being most effective. Communication channels ranged from printed products to face-to-face communication and digital media. In addition, studies specifying interpersonal communicators were highly effective. CONCLUSION The results of the review suggest that the following aspects can contribute to effective communication in child injury prevention: theory-based communication, addressing broad knowledge and further behavioral determinants, digital tailoring, and health professionals as communicators. However, a conclusive statement on the effectiveness of different communication strategies is hampered by the fact that they are not specified and/or confounded in many studies. PRACTICE IMPLICATIONS Communication strategies should be theory based and address, in addition to knowledge, behavioral determinants such as risk perception and self-efficacy. Moreover, digital tailoring is an advanced way of enhancing effectiveness and health professionals, such as pediatricians and clinic staff, are important multipliers.
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Affiliation(s)
- Paula Stehr
- Department of Media and Communication, LMU Munich, Munich, Germany.
| | | | | | - Katja Caspar
- Department of Media and Communication Science, University of Erfurt, Erfurt, Germany
| | - Annett Schulze
- Department Risk Communication, Federal Institute for Risk Assessment, Berlin, Germany
| | - Ann-Kathrin Lindemann
- Department Risk Communication, Federal Institute for Risk Assessment, Berlin, Germany
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Aboagye RG, Mireku DO, Nsiah JJ, Ahinkorah BO, Frimpong JB, Hagan JE, Abodey E, Seidu AA. Prevalence and psychosocial factors associated with serious injuries among in-school adolescents in eight sub-Saharan African countries. BMC Public Health 2022; 22:853. [PMID: 35484506 PMCID: PMC9047327 DOI: 10.1186/s12889-022-13198-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 04/08/2022] [Indexed: 11/10/2022] Open
Abstract
Background Injury is one of the major causes of death and illness among children and adolescents worldwide. We sought to investigate the prevalence of serious injury and its associated factors among in-school adolescents in eight countries in sub-Saharan Africa. Methods A sample of 14,967 in-school adolescents was drawn from the Global School-based Student Health Surveys conducted from 2012 to 2017 in eight sub-Saharan African countries. Data were collected using self-administered structured questionnaires. The prevalence of serious injuries was calculated using proportions while multivariable binary logistic regression analysis was carried out to determine the factors associated with serious injuries. Results Approximately 45% of in-school adolescents had experienced serious injuries during the past 12 months to the survey in the eight sub-Saharan African countries, with variations from 32.3% in Mauritius to 68.2% in Liberia. Adolescents who experienced bullying [aOR = 2.37, CI = 2.10, 2.68], those who engaged in physical fight [aOR = 2.14, CI = [1.87, 2.44], those who experienced an attack [aOR = 1.96, CI = [1.73, 2.22], those who felt anxious [aOR = 1.47, CI = 1.22,1.77], those who attempted suicide [aOR = 1.38, CI = 1.14, 1.65], truants [aOR = 1.33, CI = [1.17,1.51], current tobacco users [aOR = 1.42, CI = [1.01, 2.01] and current marijuana users [aOR = 1.78, CI = 1.08, 2.93] had higher odds of experiencing serious injuries. However, those whose parents or guardians respected their privacy had lower odds of experiencing serious injuries [aOR =0.78, CI = [0.68, 0.88] compared to those whose parents or guardians did not respect their privacy. Conclusion A relatively high prevalence of serious injuries among in-school adolescents was identified in the eight sub-Saharan African countries studied. Programs and interventions that target the reduction of injuries in educational institutions should take a keen interest in the factors identified in this study. To deal with injury victims, first aid services should be provided in school settings. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13198-6.
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Affiliation(s)
- Richard Gyan Aboagye
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana.
| | - Dickson Okoree Mireku
- Directorate of Academic Planning and Quality Assurance, University of Cape Coast, Cape Coast, Ghana
| | - John Jackson Nsiah
- Department of Real Estate Management, Takoradi Technical University, Takoradi, Ghana
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - James Boadu Frimpong
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - John Elvis Hagan
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana.,Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sport Sciences, Bielefeld University, Bielefeld, Germany
| | - Eric Abodey
- Department of Education and Psychology Studies, University of Cape Coast, Cape Coast, Ghana
| | - Abdul- Aziz Seidu
- Department of Real Estate Management, Takoradi Technical University, Takoradi, Ghana.,Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
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London AS, Landes SD. Attention deficit hyperactivity disorder and the age pattern of adult mortality. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2022; 67:28-39. [PMID: 34984945 PMCID: PMC9038627 DOI: 10.1080/19485565.2021.2020618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
We draw upon the life-course perspective and examine whether Attention Deficit Hyperactivity Disorder (ADHD) moderates the age pattern of adult mortality using data from the 2007 and 2012 National Health Interview Survey Sample Adult File linked to National Death Index data through 2015. Overall, 7.0% of respondents died by 2015. Discrete-time hazard analysis indicates that the log odds of mortality were significantly lower among 18 and 19 year old adults ever diagnosed with ADHD and significantly higher among 46 to 64 year old adults ever diagnosed with ADHD, with a crossover occurring at age 33. Results were similar among men and women. It is not known specifically which risks drive changes in the risk of mortality documented among persons with ADHD during the transition to adulthood, the increased risk of mortality in midlife, or whether some risks operate more or less at particular ages. Additional research can lead to targeted, age- and life-course stage-focused interventions for specific risks and contribute to the reduction of ADHD-related mortality.
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Affiliation(s)
- Andrew S London
- Sociology, Aging Studies Institute Associate, and Lerner Center for Public Health Promotion, Syracuse University, Maxwell School of Citizenship and Public Affairs, Syracuse, New York, USA
| | - Scott D Landes
- Sociology, Aging Studies Institute Associate, and Lerner Center for Public Health Promotion, Syracuse University, Maxwell School of Citizenship and Public Affairs, Syracuse, New York, USA
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Prevalence and Correlates of Serious Injuries among Adolescents in Mauritius. ScientificWorldJournal 2021; 2021:3733762. [PMID: 34955692 PMCID: PMC8709757 DOI: 10.1155/2021/3733762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 12/04/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction Injuries are a major global health problem that affects teenagers in many countries. Though several studies have been done in many countries, little is known among adolescents in Mauritius. Therefore, our paper explored the prevalence and correlates of serious injuries among adolescents in Mauritius. Methods We analysed the 2017 Global School-Based Student Health Survey (GSHS) data from Mauritius, using the Chi-square test and binomial logistic regression analysis with adjusted odds ratio (AOR) at 95% confidence interval (CI). Results The prevalence of serious injuries among adolescents in Mauritius stood at 39.0%. Also, the predictors of serious injuries included sex (AOR = 0.70, CI = 0.58–0.81), physical attack (AOR = 0.47, CI = 0.39–0.57), being bullied (AOR = 0.48, CI = 0.48–0.70), suicide ideation (AOR = 0.65, CI = 0.49–0.85), hunger (AOR = 0.65, CI = 0.48–0.86), truancy from school (AOR = 0.77, CI = 0.63–0.93), marijuana use (AOR = 0.54, CI = 0.39–0.76), alcohol consumption (AOR = 0.64, CI = 0.70–0.98), and parental neglect (AOR = 0.83, CI = 0.70–0.98). Conclusion The rate of injury among adolescents in Mauritius is moderately high, with sex, suicidal thought, hunger, truancy, drug use, and parental neglect as correlates. There is an urgent need for health promotion interventions at family, community, and school levels to deal with this level of serious injuries and the factors influencing such occurrences among these adolescents in Mauritius.
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Factors Associated with Serious Injuries among Adolescents in Ghana: Findings from 2012 Global School Health Survey. ScientificWorldJournal 2021; 2021:6622363. [PMID: 33986635 PMCID: PMC8079207 DOI: 10.1155/2021/6622363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/18/2021] [Accepted: 02/02/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction Injuries are of public health concern and the leading cause of residual disability and death among teenagers, especially in low- and middle-income countries (LMICs). In Ghana, the burden of injury among adolescents is under-reported. Hence, the study sought to determine the prevalence of serious injuries (SI) and the potential factors influencing these injuries among school children in Ghana. Methods This study was conducted in Ghana among Junior High School (JHS) and senior high school students (SHS) using the 2012 Global School-Based Student Health Survey (GSHS) data. The GSHS employed two-stage cluster sampling method. Serious injuries (SI) and independent factors were measured via self-administered questionnaires. Pearson chi-square test between each explanatory variable and serious injuries was conducted and the level of statistical significance was set at 5%. The significant variables from the chi-square test were selected for multiple logistic regression analysis. Multiple logistic regression was performed to estimate the adjusted odds ratio (AOR) at 95% confidence interval (CI). Results The prevalence of SI in the past 12 months was 66% [CI=61.8-70.2] . The most common cause of SI was fall, 36%. The common types of injuries were cut/stab wounds and broken/dislocated bone. In the multiple logistic regression analysis, after controlling for other variables, educational level (AOR = 0.64, CI = 0.44-0.90, p < 0.015), suicidal ideation (AOR = 1.58, CI = 1.00-2.48, p < 0.002), suicidal attempt (AOR = 1.88, CI = 1.29-2.72, p < 0.001), having at least one close friend (AOR = 1.49, CI = 1.17-1.89, p < 0.002), school truancy (AOR = 1.66, CI = 1.31-2.09, p < 0.000), smoking marijuana (AOR = 2.64, CI = 1.22-5.69), and amphetamine use (AOR = 2.95, CI = 1.46-5.69) were independently associated with SI. Conclusion The findings of the study established a high prevalence of SI among adolescents in Ghana, with cut/stab wound and broken/dislocated bone being the most reported type of injuries. This study also revealed that factors such as educational level, suicidal ideation, suicidal attempt, at least one close friend, school truancy, smoking marijuana, and amphetamine use are associated with SI among the adolescents. Therefore, pragmatic interventional programs should be targeted at these factors to curb the rate of SI among junior and senior school students.
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11
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Dachew BA, Scott JG, Mamun A, Alati R. Hypertensive disorders of pregnancy and emotional and behavioural problems in children: a longitudinal population-based study. Eur Child Adolesc Psychiatry 2020; 29:1339-1348. [PMID: 31758357 DOI: 10.1007/s00787-019-01443-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 11/12/2019] [Indexed: 12/31/2022]
Abstract
There is evidence that offspring of mothers who have hypertensive disorders of pregnancy (HDP) are at increased risk of adverse health outcomes. This study aims to examine the association between maternal HDP and emotional- and behavioural problems in offspring at age 11 years as reported by teachers and parents. The current study is based on the Avon Longitudinal Study of Parents and Children (ALSPAC), a prospective, population-based study that has followed a cohort of offspring since their mothers were pregnant. Childhood emotional- and behavioural problems were measured using the Strengths and Difficulties Questionnaire (SDQ), completed by parents (n = 7196) and the child's teacher (n = 7411). Maternal preeclampsia, but not gestational hypertension, was associated with teacher-reported total behavioural difficulties (RR = 1.62; 95% CI 1.03-2.52) and internalising problems in children [peer problems (RR = 1.48; 95% CI 1.06-2.08) and emotional problems (RR = 1.68; 95% CI 1.13-2.51)]. No associations between preeclampsia and/or gestational hypertension and parent-reported emotional- and behaviour problems were observed. Our study showed that children exposed to preeclampsia had higher risk of teacher-reported total behavioural difficulties and internalising problems compared with unexposed children. The findings suggest emotional- and behavioural difficulties may not be evident in all settings, hence the importance of collecting evidence from multiple informants.
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Affiliation(s)
- Berihun Assefa Dachew
- Institute for Social Science Research, The University of Queensland, 80 Meiers Road, Indooroopilly, Brisbane, QLD, 4068, Australia. .,Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia.
| | - James G Scott
- QIMR Berghofer Medical Research Institute, Herston, QLD, Australia.,Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Australia.,Metro North Mental Health, Royal Brisbane and Women's Hospital, Herston, Australia
| | - Abdullah Mamun
- Institute for Social Science Research, The University of Queensland, 80 Meiers Road, Indooroopilly, Brisbane, QLD, 4068, Australia
| | - Rosa Alati
- Institute for Social Science Research, The University of Queensland, 80 Meiers Road, Indooroopilly, Brisbane, QLD, 4068, Australia.,School of Public Health, Curtin University, Perth, WA, Australia
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12
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Arshad H, Husky MM, Goelitz D, Bitfoi A, Carta MG, Koç C, Lesinskiene S, Mihova Z, Otten R, Fermanian C, Kovess-Masfety V. Birth rank as a determinant of academic achievement:results from a European survey of primary school children. EUROPEAN JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2020. [DOI: 10.1080/17405629.2019.1700108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - Mathilde M. Husky
- Laboratoire de Psychologie EA4139, Université de Bordeaux, Bordeaux, France
| | - Dietmar Goelitz
- Social Sciences and Theology, Friedrich-Alexander-Universitaet Erlangen-Nuernberg Faculty of Humanities, Nunberg, Germany
| | - Adina Bitfoi
- The Romanian League for Mental Health, Bucharest, Romania
| | - Mauro Giovanni Carta
- Centro di Psichiatria di Consulenza e Psicosomatica Azienda Ospedaliero, Universitaria di Cagliari, Cagliari, Italy
| | - Ceren Koç
- Yeniden Health and Education Society, Istanbul, Turkey
| | - Sigita Lesinskiene
- Clinic of Psychiatry, Faculty of Medicine, University of Vilnius, Vilnius, Lithuania
| | - Zlatka Mihova
- Bulgarian Institute for Human relations, New Bulgarian University, Sofia, Bulgaria
| | - Roy Otten
- Behavioural Science Institute, Radboud University Nijmegen, Pluryn, Research & Development, Nijmegen, The Netherlands
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Agnafors S, Torgerson J, Rusner M, Kjellström AN. Injuries in children and adolescents with psychiatric disorders. BMC Public Health 2020; 20:1273. [PMID: 32838787 PMCID: PMC7445910 DOI: 10.1186/s12889-020-09283-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 07/20/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Unintentional injuries are a leading cause of morbidity and mortality in children of all ages. Prevention strategies require knowledge of risk factors, and behavior and psychiatric disorders have been suggested to influence the risk of injury during childhood. While externalizing disorders have been found to increase the risk for injuries, results are mixed regarding internalizing disorders, such as affective and anxiety conditions, and Autism Spectrum Disorders (ASD). There is a need for large scale studies relying on robust data sources. The aim of the present study was to examine the association between psychiatric disorders and injuries requiring medical attention, in a large population-based cohort of 350,000 children and adolescents in Sweden. METHODS Data were obtained from the regional health care database Vega. Psychiatric diagnoses and injury diagnoses obtained during 2014-2018 for individuals aged 0-17 years in 2016 were extracted. Descriptive statistics were used to examine differences in 5-year injury prevalence between children with and without different psychiatric diagnoses. Logistic regression was used in age-stratified models to test the association between psychiatric diagnoses and injuries requiring medical attention. RESULTS The results show an increased risk for concurrent injuries in general, but the patterns vary by age and psychiatric disorder. Externalizing disorders and anxiety conditions were associated with concurrent injuries, while individuals with ASD had a lower risk for most injuries included. Affective disorders were associated with an increased risk for wounds, concussion, complications and poisoning, while the risk for fractures was decreased. Self-inflicted injury was more common in all psychiatric conditions investigated during adolescence, except for ASD. Children and adolescents with many types of psychiatric disorders were also at increased risk for a concurrent maltreatment diagnosis. CONCLUSIONS A general pattern of increased risk for concurrent injuries in children and adolescents with most psychiatric diagnoses was found, but the associations vary by age and type of psychiatric disorder. The results add to the literature on risk factors for injuries in children and adolescents, supporting diagnosis specific patterns. Several psychiatric diagnoses were associated with a marked increase in injury risk, indicating a high burden of disease for affected individuals.
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Affiliation(s)
- Sara Agnafors
- Division of Children's and Women's health, BKV, Department of Biomedical and Clinical Sciences, Linköping University, S-581 85, Linköping, Sweden. .,Department of Research, Södra Älvsborgs Hospital, Borås, Sweden.
| | - Jarl Torgerson
- Department of Psychosis, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Marie Rusner
- Department of Research, Södra Älvsborgs Hospital, Borås, Sweden.,Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Norman Kjellström
- Department of Data Management and Analysis, Head Office, Region Västra Götaland, Skövde, Sweden
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14
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Bandyopadhyay A, Tingay K, Akbari A, Griffiths L, Bedford H, Cortina-Borja M, Walton S, Dezateux C, Lyons RA, Brophy S. Behavioural difficulties in early childhood and risk of adolescent injury. Arch Dis Child 2020; 105:282-287. [PMID: 31666244 PMCID: PMC7041499 DOI: 10.1136/archdischild-2019-317271] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 09/30/2019] [Accepted: 10/09/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To evaluate long-term associations between early childhood hyperactivity and conduct problems (CP), measured using Strengths and Difficulties Questionnaire (SDQ) and risk of injury in early adolescence. DESIGN Data linkage between a longitudinal birth cohort and routinely collected electronic health records. SETTING Consenting Millennium Cohort Study (MCS) participants residing in Wales and Scotland. PATIENTS 3119 children who participated in the age 5 MCS interview. MAIN OUTCOME MEASURES Children with parent-reported SDQ scores were linked with hospital admission and Accident & Emergency (A&E) department records for injuries between ages 9 and 14 years. Negative binomial regression models adjusting for number of people in the household, lone parent, residential area, household poverty, maternal age and academic qualification, child sex, physical activity level and country of interview were fitted in the models. RESULTS 46% of children attended A&E or were admitted to hospital for injury, and 11% had high/abnormal scores for hyperactivity and CP. High/abnormal or borderline hyperactivity were not significantly associated with risk of injury, incidence rate ratio (IRR) with 95% CI of the high/abnormal and borderline were 0.92 (95% CI 0.74 to 1.14) and 1.16 (95% CI 0.88 to 1.52), respectively. Children with borderline CP had higher injury rates compared with those without CP (IRR 1.31, 95% CI 1.09 to 1.57). CONCLUSIONS Children with high/abnormal hyperactivity or CP scores were not at increased risk of injury; however, those with borderline CP had higher injury rates. Further research is needed to understand if those with difficulties receive treatment and support, which may reduce the likelihood of injuries.
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Affiliation(s)
- Amrita Bandyopadhyay
- National Centre for Population Health and Wellbeing Research, Swansea University Medical School, Swansea, United Kingdom
- Administrative Data Research UK, Swansea University Medical School, Swansea, United Kingdom
| | - Karen Tingay
- Office for National Statistics, Cardiff Road, Newport, Wales, UK
| | - Ashley Akbari
- Administrative Data Research UK, Swansea University Medical School, Swansea, United Kingdom
- Health Data Research UK, Swansea University Medical School, Swansea, United Kingdom
| | - Lucy Griffiths
- Health Data Research UK, Swansea University Medical School, Swansea, United Kingdom
- Life Course Epidemiology and Biostatistics, UCL Great Ormond Street Institute of Child Health, UCL, London, UK
| | - Helen Bedford
- Life Course Epidemiology and Biostatistics, UCL Great Ormond Street Institute of Child Health, UCL, London, UK
| | - Mario Cortina-Borja
- Clinical Epidemiology, Nutrition and Biostatistics, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Suzanne Walton
- Life Course Epidemiology and Biostatistics, UCL Great Ormond Street Institute of Child Health, UCL, London, UK
| | - Carol Dezateux
- Centre for Primary Care and Public Health, Queen Mary University of London, London, UK
| | - Ronan A Lyons
- National Centre for Population Health and Wellbeing Research, Swansea University Medical School, Swansea, United Kingdom
- Administrative Data Research UK, Swansea University Medical School, Swansea, United Kingdom
- Health Data Research UK, Swansea University Medical School, Swansea, United Kingdom
| | - Sinead Brophy
- National Centre for Population Health and Wellbeing Research, Swansea University Medical School, Swansea, United Kingdom
- Administrative Data Research UK, Swansea University Medical School, Swansea, United Kingdom
- Health Data Research UK, Swansea University Medical School, Swansea, United Kingdom
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Auger N, Low N, Lee GE, Ayoub A, Luu TM. Maternal stress and anxiety disorders and the longitudinal risk of fractures in children. Bone 2020; 130:115143. [PMID: 31706049 DOI: 10.1016/j.bone.2019.115143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 10/15/2019] [Accepted: 11/05/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND Maternal stress and anxiety are associated with adverse pregnancy outcomes, but the association with future childhood injuries is unclear, especially risk of orthopedic fractures. METHODS We conducted a longitudinal study of 773,339 newborns in Quebec, Canada between 2006 and 2018. We identified women with stress or anxiety disorders before or after delivery, and computed the incidence of future operative fractures in offspring. We estimated hazard ratios (HR) with 95% confidence intervals (CI) for the association of maternal stress and anxiety disorders with the risk of pediatric fractures, adjusted for maternal and infant characteristics. RESULTS Incidence of any fracture was higher for maternal stress (20.5 per 10,000 person-years) and anxiety (19.8 per 10,000 person-years) than no disorder (15.3 per 10,000 person-years). Maternal stress was associated with 1.17 times the risk of pediatric fractures (95% CI 1.00-1.38), and anxiety was associated with 1.26 times the risk (95% CI 1.07-1.47), compared with no disorder. Stress was predominantly linked with fall-related fractures (HR 1.26, 95% CI 1.06-1.50), and anxiety with assault-related fractures (HR 2.97, 95% CI 1.50-5.89). The association of stress with fall-related fractures was more prominent after 36 months of age, whereas anxiety was linked with assault-related fractures before 6 months. CONCLUSION Stress and anxiety disorders before or after delivery are associated with the future risk of fractures in children. Women with a history of stress or anxiety disorders may benefit from counselling and social support for child fracture prevention.
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Affiliation(s)
- Nathalie Auger
- University of Montreal Hospital Research Centre, Montreal, Quebec, Canada; Institut national de santé publique du Québec, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada; Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Quebec, Canada.
| | - Nancy Low
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Ga Eun Lee
- University of Montreal Hospital Research Centre, Montreal, Quebec, Canada; Institut national de santé publique du Québec, Montreal, Quebec, Canada
| | - Aimina Ayoub
- University of Montreal Hospital Research Centre, Montreal, Quebec, Canada; Institut national de santé publique du Québec, Montreal, Quebec, Canada
| | - Thuy Mai Luu
- Department of Pediatrics, Sainte-Justine University Hospital Research Centre, University of Montreal, Montreal, Quebec, Canada
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16
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Jiménez-Aguilar DP, Montoya-Jaramillo LM, Benjumea-Bedoya D, Castro-Álvarez JF. Traumatismo craneoencefálico en niños. Hospital General de Medellín y Clínica Somer de Rionegro, 2010-2017. IATREIA 2019. [DOI: 10.17533/udea.iatreia.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objetivo: describir las características sociodemográficas, aspectos clínicos y complicaciones de los niños de 0 a 10 años de edad que sufrieron traumatismo craneoencefálico, atendidos en el Hospital General de Medellín y en la Clínica Somer de Rionegro entre los años 2010 y 2017.Métodos: estudio descriptivo retrospectivo, toma como fuente de información las historias clínicas de los niños con diagnósticos relacionados con el traumatismo craneoencefálico entre 2010-2017. Se calcularon las proporciones de las variables sociodemográficas, circunstanciales, espacio-temporales y clínicas.Resultados: se encontraron 224 pacientes con traumatismo craneoencefálico, el 64,7 % de los casos fueron de sexo masculino, la edad promedio fue de 4,5 años. El trauma ocurrió con mayor frecuencia en el domicilio del paciente entre los días de la semana en las horas de la tarde. La causa principal del trauma fue caída (75 %), seguido por accidentes de tránsito (13,3 %). La gravedad del traumatismo se midió con la escala de coma de Glasgow, el 78 % fue leve, hubo un caso fatal y 7 (3 %) tuvieron complicaciones motoras durante la hospitalización.Conclusión: los hallazgos de este estudio coinciden con las principales características del traumatismo craneoencefálico de la población pediátrica en el mundo, amplía la información regional y local para el desarrollo de estrategias de prevención, diagnóstico y seguimiento a largo plazo de los pacientes.
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17
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Caldwell A, Qasimyar H, Shumate L, Anderson MP, Cherry A, Bryant C, Bax A. Structured Curriculum to Improve Pediatric Resident Confidence and Skills in Providing Parenting Advice. J Osteopath Med 2019; 119:748-755. [PMID: 31657828 DOI: 10.7556/jaoa.2019.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Context Residents receive little parenting education despite its potential to improve parenting behavior and decrease child maltreatment despite the inclusion of parenting content on board certification examinations. Teaching residents how to discuss parenting and foster positive parent-child relationships is essential to treating the whole person in osteopathic pediatric medicine. Objective To improve pediatric and internal medicine-pediatric residents' knowledge, confidence, and skills in providing parenting advice. Methods Four toddler parenting and discipline modules were developed. During continuity clinic, residents viewed and discussed modules with faculty. Residents completed a confidence and knowledge questionnaire before and after the curriculum, provided a self-report of use of skills learned, and completed a feasibility survey. Faculty also completed a feasibility survey. Results Forty-one of 61 residents (67%) participated in the study. Before participation, the median (interquartile range [IQR]) resident score for confidence in giving advice was 6.0 (4.0-7.0) (on a 10-point scale), increasing to 7.0 (6.0-8.0) for those completing 1 to 3 modules and 8.0 (8.0-9.0) for those completing 4 modules. Median (IQR) score on board-style questions was 8.0 (7.0-9.0) (on a 12-point scale) before participating in the modules and 8.5 (7.5-9.5) for those completing 1 to 3 modules and 9.0 (7.0-9.0) for those completing 4 modules after participation; the increase was not statistically significant. Nine faculty and 29 residents completed the modules and responded to the exit survey regarding feasibility and acceptability of the curriculum. On a 4-point scale (4 being excellent), sessions had an overall mean (SD) rating of 3.7 (0.5) by faculty and 3.5 (0.5) by residents. Most residents (27 [93.1%]) reported interest in more modules, and 28 residents (96.6%) reported using information learned from the modules during clinic visits. Conclusion Confidence delivering parenting advice increased among residents who completed the curriculum modules. Faculty and residents reported high feasibility ratings, and residents endorsed application of skills during clinic visits and interest in more modules.
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Wang Z, Chen H, Yu T, Liu S, Hu M. Status of injuries as a public health burden among children and adolescents in China: A systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e17671. [PMID: 31702619 PMCID: PMC6855559 DOI: 10.1097/md.0000000000017671] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Injuries among children and adolescents remain a major public health problem in China. In the present study, we undertook a systematic review and meta-analysis of the published literature of epidemiological studies investigating injuries among children and adolescents in China and aimed to describe the status of injury among children and adolescents (aged 0-19 years) in China nationwide. A random-effects meta-analysis model was used to calculate the pooled prevalence of injury with 95% confidence intervals (CIs) across studies. The potential heterogeneity moderators were identified by subgroup and sensitivity analysis. A total of 775,615 children and adolescents were included in this study. Overall, the pooled injury prevalence among children and adolescents aged 0 to 19 years was 23.0% (95% CI 20.0%-27.0%) in studies using 1996 version of injury definition, and 13.0% (95% CI 10.0%-17.0%) in studies using 2004 version of injury definition. Relevant heterogeneity moderators have been identified by subgroup analysis. Sensitivity analysis yielded consistent results. CONCLUSION Our study shows a moderately high injury prevalence among children and adolescents aged 0 to 19 years in China, more prevention policies and programs should be urgently developed to decrease the occurrence of child and adolescent injury.
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Affiliation(s)
- Ziyu Wang
- Department of Epidemiology and Health Statistics, XiangYa School of Public Health, Central South University, Changsha
| | - Hui Chen
- Department of Medicine, Betta Pharmaceuticals Co., Ltd., Hangzhou
| | - Taolin Yu
- Department of Epidemiology and Health Statistics, XiangYa School of Public Health, Central South University, Changsha
| | - Siyun Liu
- Department of Medical Records, Chongqing General Hospital, Chongqing, China
| | - Ming Hu
- Department of Epidemiology and Health Statistics, XiangYa School of Public Health, Central South University, Changsha
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Kizuki M, Ochi M, Isumi A, Kato T, Fujiwara T. Parental Time of Returning Home From Work and Child Mental Health Among First-Year Primary School Students in Japan: Result From A-CHILD Study. Front Pediatr 2018; 6:179. [PMID: 30013959 PMCID: PMC6036177 DOI: 10.3389/fped.2018.00179] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 05/31/2018] [Indexed: 01/14/2023] Open
Abstract
Introduction: Child mental health is known to be influenced by parental work hours. Although literature suggests that parent-child interaction mediates the association, few studies have directly measured the parental time of returning home from work. We analyzed data from a school-based survey to examine the association between parental time of returning home from work and child mental health. Methods: We used a sample of 2,987 first-year primary school students derived from the Adachi Child Health Impact of Living Difficulty (A-CHILD) study that examined the impact of family environment and lifestyle on child health in Adachi City, Tokyo, Japan. We analyzed the associations between reported parental time of returning home and the continuous Strengths and Difficulties Questionnaire (SDQ) scores using multivariable regression modeling. Results: Children whose parents both returned home late (later than 6 p.m. for the mother and later than 8 p.m. for the father), or at irregular times, had higher scores in total difficulties (β = 1.20, 95% CI: 0.55 to 1.85), the "conduct problems" subscale (β = 0.37, 95% CI: 0.13 to 0.60), and the hyperactivity/inattention subscale (β = 0.53, 95% CI: 0.24 to 0.82) compared with children whose parents both returned home earlier. Mediation analyses indicated that the percentage of the total association between parental time of returning home and the SDQ scores, which was mediated by parent-child interaction, was 20% (95% CI: 10 to 46) for total difficulties, 17% (95% CI: 7 to 49) for conduct problems, and 23% (95% CI: 11 to 52) for hyperactivity/inattention. Conclusions: Late or irregular returning home times for both parents had an adverse effect on child mental health, and the relationship was partly mediated by reduced frequency of parent-child interaction.
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Affiliation(s)
- Masashi Kizuki
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Manami Ochi
- Japan Support Center for Suicide Countermeasures, Tokyo, Japan
| | - Aya Isumi
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tsuguhiko Kato
- Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
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Ruiz-Goikoetxea M, Cortese S, Aznarez-Sanado M, Magallón S, Alvarez Zallo N, Luis EO, de Castro-Manglano P, Soutullo C, Arrondo G. Risk of unintentional injuries in children and adolescents with ADHD and the impact of ADHD medications: A systematic review and meta-analysis. Neurosci Biobehav Rev 2017; 84:63-71. [PMID: 29162520 DOI: 10.1016/j.neubiorev.2017.11.007] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Revised: 11/08/2017] [Accepted: 11/14/2017] [Indexed: 01/01/2023]
Abstract
A systematic review with meta-analyses was performed to: 1) quantify the association between ADHD and risk of unintentional physical injuries in children/adolescents ("risk analysis"); 2) assess the effect of ADHD medications on this risk ("medication analysis"). We searched 114 databases through June 2017. For the risk analysis, studies reporting sex-controlled odds ratios (ORs) or hazard ratios (HRs) estimating the association between ADHD and injuries were combined. Pooled ORs (28 studies, 4,055,620 individuals without and 350,938 with ADHD) and HRs (4 studies, 901,891 individuals without and 20,363 with ADHD) were 1.53 (95% CI=1.40,1.67) and 1.39 (95% CI=1.06,1.83), respectively. For the medication analysis, we meta-analysed studies that avoided the confounding-by-indication bias [four studies with a self-controlled methodology and another comparing risk over time and groups (a "difference in differences" methodology)]. The pooled effect size was 0.879 (95% CI=0.838,0.922) (13,254 individuals with ADHD). ADHD is significantly associated with an increased risk of unintentional injuries and ADHD medications have a protective effect, at least in the short term, as indicated by self-controlled studies.
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Affiliation(s)
- Maite Ruiz-Goikoetxea
- Servicio de Urgencias Extrahospitalarias, Servicio Navarro de Salud-Osasunbidea, Pamplona, Spain.
| | - Samuele Cortese
- Center for Innovation in Mental Health, Academic Unit of Psychology, University of Southampton, Southampton, UK; Faculty of Medicine, Clinical and Experimental Sciences (CNS and Psychiatry), University of Southampton, Southampton, UK; Department of Child and Adolescent Psychiatry, NYU Langone Medical Center, New York, NY, USA.
| | | | - Sara Magallón
- Facultad de Educación y Psicología, Universidad de Navarra, Pamplona, Spain.
| | - Noelia Alvarez Zallo
- Servicio de Urgencias Extrahospitalarias, Servicio Navarro de Salud-Osasunbidea, Pamplona, Spain.
| | - Elkin O Luis
- Facultad de Educación y Psicología, Universidad de Navarra, Pamplona, Spain.
| | - Pilar de Castro-Manglano
- Departamento de Psiquiatría y Psicología Médica, Unidad de Psiquiatría Infantil y Adolescente, Clínica Universidad de Navarra, Pamplona, Spain.
| | - Cesar Soutullo
- Departamento de Psiquiatría y Psicología Médica, Unidad de Psiquiatría Infantil y Adolescente, Clínica Universidad de Navarra, Pamplona, Spain.
| | - Gonzalo Arrondo
- Instituto Cultura y Sociedad (ICS), Grupo Mente-Cerebro, Universidad de Navarra, Pamplona, Spain.
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Ruiz-Goikoetxea M, Cortese S, Aznarez-Sanado M, Magallon S, Luis EO, Zallo NA, de Castro-Manglano P, Soutullo C, Arrondo G. Risk of unintentional injuries in children and adolescents with ADHD and the impact of ADHD medications: protocol for a systematic review and meta-analysis. BMJ Open 2017; 7:e018027. [PMID: 28951416 PMCID: PMC5623547 DOI: 10.1136/bmjopen-2017-018027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION Attention-deficit hyperactivity disorder (ADHD) has been related to increased rates of unintentional injuries. However, the magnitude of the effect and to which extent variables such as sex, age or comorbidity can influence this relationship is unknown. Additionally, and importantly, it is unclear if, and to which degree, ADHD medications can decrease the number of unintentional injuries. Due to the amount of economic and social resources invested in the treatment of injuries, filling these gaps in the literature is highly relevant from a public health standpoint. Here, we present a protocol for a systematic review and meta-analysis to estimate the relationship between ADHD and unintentional injuries and assess the impact of pharmacological treatment for ADHD METHODS AND ANALYSIS: We will combine results from 114 bibliographic databases for studies relating ADHD and risk of injuries. Bibliographic searches and data extraction will be carried out independently by two researchers. The studies' risk of bias will be assessed using the Newcastle-Ottawa Scale. Articles reporting ORs or HRs of suffering an injury in ADHD compared with controls (or enough data to calculate them) will be combined using Robust Variance Estimation, a method that permits to include multiple non-independent outcomes in the analysis. All analyses will be carried out in Stata. Age, sex and comorbid conduct disorders will be considered as potential causes of variance and their effect analysed through meta-regression and subgroup analysis. Sensitivity analyses will exclude articles with longer follow-ups, non-stringent definitions of ADHD or controls and statistically uncontrolled/controlled outcomes. Studies implementing a self-controlled case series methodology to investigate if ADHD drugs reduce the risk of injuries will be combined with a generalised linear mixed model using the Poisson distribution and a log link function. REGISTRATION DETAILS PROSPERO-Prospective Register of Systematic Reviews (CRD42017064967).
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Affiliation(s)
- Maite Ruiz-Goikoetxea
- Servicio Navarro de Salud-Osasunbidea, Servicio de Urgencias Extrahospitalarias, Pamplona, Spain
| | - Samuele Cortese
- Center for Innovation in Mental Health, University of Southampton, Academic Unit of Psychology, Southampton, UK
- Faculty of Medicine, Clinical and Experimental Sciences (CNS and Psychiatry), University of Southampton, Southampton, UK
- Department of Child and Adolescent Psychiatry, NYU Langone Medical Center, New York, NY, USA
| | | | - Sara Magallon
- Facultad de Educación y Psicología, Universidad de Navarra, Pamplona, Spain
| | - Elkin O Luis
- Facultad de Educación y Psicología, Universidad de Navarra, Pamplona, Spain
| | - Noelia Alvarez Zallo
- Servicio Navarro de Salud-Osasunbidea, Servicio de Urgencias Extrahospitalarias, Pamplona, Spain
| | - Pilar de Castro-Manglano
- Departamento de Psiquiatría y Psicología Médica, Unidad de Psiquiatría Infantil y Adolescente, Clínica Universidad de Navarra, Pamplona, Spain
| | - Cesar Soutullo
- Departamento de Psiquiatría y Psicología Médica, Unidad de Psiquiatría Infantil y Adolescente, Clínica Universidad de Navarra, Pamplona, Spain
| | - Gonzalo Arrondo
- Instituto Cultura y Sociedad (ICS), Grupo Mente-Cerebro, Universidad de Navarra, Pamplona, Spain
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22
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Kovess Masfety V, Lesinskiene S, Husky MM, Boyd A, Ha P, Fermanian C, Pez O. Risk factors for child mental health problems in Lithuania: The role of parental nationality. Compr Psychiatry 2017; 73:15-22. [PMID: 27852002 DOI: 10.1016/j.comppsych.2016.10.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Revised: 09/22/2016] [Accepted: 10/22/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND We compare the mental health status of children who reside in Lithuania with parents who are either Lithuanian nationals or non-Lithuanian nationals. METHOD Data were drawn from the School Child Mental Health Europe survey (SCMHE), a cross-sectional survey of school children aged 6-11years. A total of 1152 Lithuanian children participated, among them 11.7% from a non-Lithuanian family. Child mental health was assessed using the Dominique Interactive (DI) and the parent- and teacher Strength and Difficulties Questionnaire (SDQ). Parental attitudes were evaluated, and socio-demographics were collected. RESULTS Overall 26.7% of non-Lithuanian versus 17.2% of Lithuanian children reported having an internalizing disorder (p=0.01) mainly due to separation anxiety (16.4% versus 10.2%, p=0.04). Odds ratio (OR) for child-reported internalizing disorders was 1.86 (95% CI=1.17-2.96) once adjusted for other factors including being a girl, to be younger, parental unemployment and low caring and low autonomy parental attitudes which were associated with greater odds of internalizing disorders. In addition, 31.9% of non-Lithuanian reported suicidal thoughts versus 22.0% of Lithuanian children p=.02); OR=1.60 (95% CI=1.04-2.46) once adjusted for single parent, parental unemployment, parental alcohol problems and overreactivity attitude. CONCLUSIONS Being a non-national minority in Lithuania is a risk factor for child mental health. These findings suggest that further studies are needed to inform local policy-makers on targeted prevention and intervention programs in these children.
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Affiliation(s)
- Viviane Kovess Masfety
- EA 4057 Paris Descartes University, Ecole des Hautes Etudes de Santé Publique (EHESP), Paris, France
| | - Sigita Lesinskiene
- Psychiatry Clinic, School of Medicine, University of Vilnius, Vilnius, Lithuania
| | - Mathilde M Husky
- University of Bordeaux, Institut Universitaire de France, Laboratoire de Psychologie EA4139, Bordeaux, France.
| | - Anders Boyd
- INSERM UMRS1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Phuong Ha
- EA 4057 Paris Descartes University, Ecole des Hautes Etudes de Santé Publique (EHESP), Paris, France
| | - Christophe Fermanian
- EA 4057 Paris Descartes University, Ecole des Hautes Etudes de Santé Publique (EHESP), Paris, France
| | - Ondine Pez
- EA 4057 Paris Descartes University, Ecole des Hautes Etudes de Santé Publique (EHESP), Paris, France
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23
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Association Between Maternal Postpartum Depression and Unintentional Injury Among 4-Month-Old Infants in Japan. Matern Child Health J 2016; 20:326-36. [PMID: 26520154 DOI: 10.1007/s10995-015-1832-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Unintentional injury among infants is a major public health issue; however, the relationship between unintentional infant injury and postpartum depression remains unclear. In this study, we aim to investigate the association between the two. METHODS We administered an original questionnaire to mothers participating in a 3- or 4-month health check-up program (target n = 9707). This questionnaire assessed infant health, including types of unintentional injury experiences used in previous study, and maternal mental health such as postpartum depression, by the validated screening tool, the Edinburgh Postnatal Depression Scale (EPDS). Associations between infant injury and postpartum depression were assessed using logistic regression adjusted for covariates, including parental, infant, and household characteristics. RESULTS In total, 6534 women responded to the questionnaire with valid answers on the EPDS (valid response rate, 67 %). Of the sample, 9.8 % of infants experienced unintentional injury (fall: 5.6 %; near-drowning: 1.2 %), and 9.5 % of mothers had postpartum depression (EPDS score of 9+). After adjusting for covariates, postpartum depression was significantly positively associated with any unintentional injury (odds ratio [OR] 1.59, 95 % confidence interval [CI] 1.24-2.04), and falls (OR 1.41, 95 % CI 1.02-1.95), although near-drowning was not significantly associated. CONCLUSION Postpartum depression might be a risk factor for unintentional injury of infants aged up to 4 months. Further prospective studies are needed to confirm the association between postpartum depression and unintentional injury of infants.
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Santagati G, Vezzosi L, Angelillo IF. Unintentional Injuries in Children Up to Six Years of Age and Related Parental Knowledge, Attitudes, and Behaviors in Italy. J Pediatr 2016; 177:267-272.e2. [PMID: 27492869 DOI: 10.1016/j.jpeds.2016.06.083] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 05/31/2016] [Accepted: 06/28/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To describe risk factors associated with unintentional injuries among children aged <6 years and to examine parents' level of knowledge, attitudes, and behaviors about pediatric injuries and related preventive measures. STUDY DESIGN A cross-sectional survey was conducted between May and July 2015 on a random sample of 794 parents of 3- to 6-year-old children through a self-administered anonymous questionnaire. RESULTS A total of 409 parents participated. Two-thirds of the children had experienced at least 1 unintentional injury in the previous 12 months. More than one-half of these children were boys. The leading cause was falls; the injuries occurred mainly at home, and only 9.2% were brought for attention to an emergency department. Parents who did not believe that it is possible to prevent unintentional injuries were more likely to have had a child injured. Approximately 70% of respondents were aware of security measures to prevent pediatric injuries, and this knowledge was more prevalent in older parents and in those with at least a college level of education compared with those with a middle school education. The perceived utility of education about preventive measures of pediatric injuries had a mean value of 8.9 on a Likert scale of 1-10 (1, not useful, to 10, very useful) and was significantly higher in mothers. CONCLUSIONS This study highlights a clear need for public health educational programs for parents regarding prevention of unintentional injuries in children as a valuable tool to increase safety and injury prevention and to reduce risks, because the majority of such injuries occur at home.
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Affiliation(s)
- Gabriella Santagati
- Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Luigi Vezzosi
- Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Italo F Angelillo
- Department of Experimental Medicine, Second University of Naples, Naples, Italy.
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London AS, Landes SD. Attention Deficit Hyperactivity Disorder and adult mortality. Prev Med 2016; 90:8-10. [PMID: 27343403 DOI: 10.1016/j.ypmed.2016.06.021] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Revised: 06/13/2016] [Accepted: 06/21/2016] [Indexed: 11/30/2022]
Abstract
This study examines the relationship between self-reported ADHD and adult mortality over a four-year period, and whether ADHD is associated with underlying cause of death (accidents versus all others). If ADHD increases mortality risk through accidents, then interventions may be designed and implemented to reduce risk and prevent premature death. We estimate descriptive statistics and multivariate logistic regression models using data from the 2007 U.S. National Health Interview Survey (NHIS) Sample Adult File linked to National Death Index (NDI) data through 2011 (N=23,352). Analyses are weighted and standard errors are adjusted for the complex sampling design. We find that the odds of dying are significantly higher among those with ADHD than among those without ADHD net of exogenous sociodemographic controls (adjusted odds ratio=1.78, 95% confidence interval=1.01, 3.12). Although marginally non-significant, accidental death is more common among those with ADHD than among those without ADHD (13.2% versus 4.3%, p=0.052). Few population-representative studies examine the relationship between ADHD and adult mortality due to data limitations. Using NHIS data linked to the NDI, we are only able to observe a few deaths among adults with ADHD. However, ADHD is associated with significantly higher odds of dying for adults and results suggest that accidents may be an underlying cause of death more often for decedents with ADHD. Future research should further examine the mechanisms linking ADHD to adult mortality and the extent to which mortality among persons with ADHD is preventable. Regular measurement of ADHD among adults in the NHIS is warranted.
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Affiliation(s)
- Andrew S London
- Syracuse University, Maxwell School of Citizenship & Public Affairs, Department of Sociology, Aging Studies Institute, and Center for Policy Research, 314 Lyman Hall, Syracuse, NY 13244-1020, United States.
| | - Scott D Landes
- University of North Florida, Department of Sociology, Anthropology, and Social Work, 1 UNF Drive, Jacksonville, FL 32224-7699, United States.
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Nikolas MA, Elmore AL, Franzen L, O'Neal E, Kearney JK, Plumert JM. Risky bicycling behavior among youth with and without attention-deficit hyperactivity disorder. J Child Psychol Psychiatry 2016; 57:141-8. [PMID: 26610867 PMCID: PMC8771970 DOI: 10.1111/jcpp.12491] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/19/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Injury risk from car-bicycle collisions is particularly high among youth with attention-deficit hyperactivity disorder (ADHD). Here, we capitalized on advances in virtual environment technology to safely and systematically examine road-crossing behavior among child cyclists with and without ADHD. METHODS Sixty-three youth (26 with ADHD, 37 non-ADHD controls) ages 10-14 years crossed 12 intersections with continuous cross-traffic while riding a high-fidelity bicycling simulator. Traffic density (i.e., temporal gaps between vehicles) was manipulated to examine the impact of varying traffic density on behavioral indices of road crossing, including gap selection, timing of entry into the roadway, time to spare when exiting the roadway, and close calls with oncoming cars. In addition, parents filled out questionnaires assessing their child's ADHD symptomatology, temperamental characteristics, bicycling experience, and injury history. RESULTS ADHD youth largely chose the same size gaps as non-ADHD youth, although ADHD youth were more likely to select smaller gap sizes following exposure to high-density traffic. In addition, youth with ADHD demonstrated poorer movement timing when entering the intersection, resulting in less time to spare when exiting the roadway. Hyperactivity-impulsivity symptoms were specifically associated with selection of smaller gaps, whereas timing deficits were specifically associated with inattention and inhibitory control. CONCLUSION Findings highlight two related yet potentially dissociable mechanisms that may influence injury risk among youth with ADHD and provide a foundation for development of injury prevention strategies.
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Affiliation(s)
| | | | - Luke Franzen
- Department of Psychology University of Iowa Iowa City IA USA
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Effect of drugs on the risk of injuries in children with attention deficit hyperactivity disorder: a prospective cohort study. Lancet Psychiatry 2015; 2:702-709. [PMID: 26249301 DOI: 10.1016/s2215-0366(15)00271-0] [Citation(s) in RCA: 113] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 05/19/2015] [Accepted: 05/28/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Injuries represent the largest disease burden and most common cause of death in children. Attention deficit hyperactivity disorder (ADHD) is associated with increased mortality, with accidents being the most common cause of death in ADHD. However, it is not known whether pharmacological treatment has any modifying effect on the risk of injuries in children and adolescents with ADHD. METHODS Using Danish national registers, we followed a cohort of 710 120 individuals, including 4557 individuals diagnosed with ADHD before age 10 years. Using a quasi-experimental, difference-in-difference design, we estimated the odds ratios (ORs) for injuries and the mean change in prevalence rates of injuries and emergency ward visits before and after treatment, with matched untreated children with ADHD at the same age serving as controls. FINDINGS Children with ADHD were more likely to sustain injuries, compared with children without ADHD, at age 10 years (adjusted OR=1·29, 95% CI 1·22-1·37) and at age 12 years (adjusted OR=1·30, 1·23-1·37). From age 5 to 10 years, the prevalence of injuries in children with ADHD who were treated with ADHD drugs decreased from 19% to 14%, compared with a prevalence of about 17% in non-treated children with ADHD. This corresponded to an adjusted difference-in-difference reduction in prevalence of injuries at age 10 years of 31·5% (8·2-54·8) and 43·5% (18·1-69·0) at age 12 years due to treatment. Pharmacological treatment also reduced the prevalence of emergency ward visits at age 10 years (28·2%, 6·3-50·1) and age 12 years (45·7%, 25·8-65·7). INTERPRETATION Children with ADHD had an increased risk of injuries compared with other children. Treatment with ADHD drugs reduced the risk of injuries by up to 43% and emergency ward visits by up to 45% in children with ADHD. Taken together with previous findings of accidents being the most common cause of death in individuals with ADHD, these results are of major public health importance. FUNDING The Lundbeck Foundation, the Danish Council for Independent Research, Centre For Integrated Register-based Research at Aarhus University, the Region of Southern Denmark Research Foundation, and Wørzner's Foundation.
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28
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Kovess V, Carta MG, Pez O, Bitfoi A, Koç C, Goelitz D, Kuijpers R, Lesinskiene S, Mihova Z, Otten R. The School Children Mental Health in Europe (SCMHE) Project: Design and First Results. Clin Pract Epidemiol Ment Health 2015; 11:113-23. [PMID: 25834631 PMCID: PMC4378028 DOI: 10.2174/1745017901511010113] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 10/03/2014] [Accepted: 10/05/2014] [Indexed: 11/22/2022]
Abstract
Background : The School Children Mental Health in Europe (SCMHE) project aims to build up a set of indicators to collect and monitor children's mental health in an efficient and comparable methodology across the EU countries. It concerns primary schools children aged 6 to 11 years a range where few data are available whereas school interventions are promising. Methods : Three informants were used: parents, teachers and children. In selecting instruments language, instruments were selected according to the easiness to translate them: SDQ (Strengths and Difficulties Questionnaire) for parents and teachers and DI (Dominic Interactive). A two-step procedure was used: schools randomization then six children by class in each grade. Results : 9084 children from seven countries (Italy, Netherlands, Germany, Romania, Bulgaria, Lithuania, and Turkey) completed the Dominic Interactive in their own language. 6563 teachers and 6031 parents completed their questionnaire, and a total of 5574 interviews have been completed by the 3 informants. The participation rate of the children with parents in the participating schools was about 66.4%. As expected teachers report more externalised problems and less internalised problems than parents. Children report more internalised problems than parents and teachers. Boys have consistently more externalised problems than girls and this is the reverse for internalised problems. Combining the diverse informants and impairment levels children with problems requiring some sort of mental health care were about 9.9%: 76% did not see any mental health professional: 78.7% In Eastern countries 63.1% in Western Europe.
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Affiliation(s)
- Viviane Kovess
- EHESP Rennes, Sorbonne Paris Cite, EA 4057 Paris Descartes University, Paris, France
| | - Mauro Giovanni Carta
- Centro di Psichiatria di Consulenza e Psicosomatica Azienda Ospedaliero Universitaria di Cagliari
| | - Ondine Pez
- EHESP Rennes, Sorbonne Paris Cite, EA 4057 Paris Descartes University, Paris, France
| | - Adina Bitfoi
- The Romanian League for Mental Health, Bucharest, Romania
| | - Ceren Koç
- Yeniden Health and Education Society, Istanbul, Turkey
| | - Dietmar Goelitz
- Institute of Psychology, University of Koblenz-Landau (Campus Koblenz), Koblenz, Germany
| | - Rowella Kuijpers
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Sigita Lesinskiene
- Clinic of Psychiatry, Faculty of Medicine, University of Vilnius, Vilnius, Lithuania
| | | | - Roy Otten
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
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