ResearchPad - traumatic-injury-risk-factors https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[Determinants of HIV testing among Filipino women: Results from the 2013 Philippine National Demographic and Health Survey]]> https://www.researchpad.co/article/elastic_article_13810 The prevalence of having ever tested for HIV in the Philippines is very low and is far from the 90% target of the Philippine Department of Health (DOH) and UNAIDS, thus the need to identify the factors associated with ever testing for HIV among Filipino women.MethodsWe analysed the 2013 Philippine National Demographic and Health Survey (NDHS). The NDHS is a nationally representative survey which utilized a two-stage stratified design to sample Filipino women aged 15–49. We considered the following exposures in our study: socio-demographic characteristics of respondent and her partner (i.e., age of respondent, age of partner, wealth index, etc.), sexual practices and contraception (i.e., age at first intercourse, condom use, etc.), media access, tobacco use, HIV knowledge, tolerance to domestic violence, and women’s empowerment. The outcome variable is HIV testing. We used logistic regression for survey data to study the said associations.ResultsOut of 16,155 respondents, only 372 (2.4%) have ever tested for HIV. After adjusting for confounders, having tertiary education (adjusted odds ratio (aOR) = 2.15; 95% Confidence Interval (CI): 1.15–4.04), living with partner (aOR = 1.72; 95% CI: 1.19–2.48), tobacco use (aOR = 1.87; 95% CI: 1.13–3.11); belonging to the middle class (aOR = 2.72; 95% CI: 1.30–5.67), richer (aOR = 3.00; 95% CI: 1.37–5.68), and richest (aOR = 4.14; 95% CI: 1.80–5.91) populations, having weekly television access (aOR = 1.75; 95% CI: 1.04–2.94) or internet access (aOR = 2.01; 95% CI: 1.35–3.00), living in a rural area (aOR = 1.87; 95% CI: 1.34–2.61); and being a Muslim (aOR = 2.30; 95% CI: 1.15–4.57) were associated with ever testing for HIV.ConclusionsThe low percentage of respondents who test for HIV is a call to further strengthen efforts to promote HIV testing among Filipino women. Information on its determinants can be used to guide the crafting and implementation of interventions to promote HIV testing to meet DOH and UNAIDS targets. ]]> <![CDATA[Life within a limited radius: Investigating activity space in women with a history of child abuse using global positioning system tracking]]> https://www.researchpad.co/article/elastic_article_7709 Early experiences of childhood sexual or physical abuse are often associated with functional impairments, reduced well-being and interpersonal problems in adulthood. Prior studies have addressed whether the traumatic experience itself or adult psychopathology is linked to these limitations. To approach this question, individuals with posttraumatic stress disorder (PTSD) and healthy individuals with and without a history of child abuse were investigated. We used global positioning system (GPS) tracking to study temporal and spatial limitations in the participants’ real-life activity space over the course of one week. The sample consisted of 228 female participants: 150 women with PTSD and emotional instability with a history of child abuse, 35 mentally healthy women with a history of child abuse (healthy trauma controls, HTC) and 43 mentally healthy women without any traumatic experiences in their past (healthy controls, HC). Both traumatized groups—i.e. the PTSD and the HTC group—had smaller movement radii than the HC group on the weekends, but neither spent significantly less time away from home than HC. Some differences between PTSD and HC in movement radius seem to be related to correlates of PTSD psychopathology, like depression and physical health. Yet group differences between HTC and HC in movement radius remained even when contextual and individual health variables were included in the model, indicating specific effects of traumatic experiences on activity space. Experiences of child abuse could limit activity space later in life, regardless of whether PTSD develops.

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<![CDATA[Effectiveness of the Common Elements Treatment Approach (CETA) in reducing intimate partner violence and hazardous alcohol use in Zambia (VATU): A randomized controlled trial]]> https://www.researchpad.co/article/N3889b1ed-7187-41ba-b4d5-94f42ba3d649

Background

Both intimate partner violence (IPV) and alcohol misuse are highly prevalent, and partner alcohol misuse is a significant contributor to women’s risk for IPV. There are few evidence-based interventions to address these problems in low- and middle-income countries (LMICs). We evaluated the effectiveness of an evidence-based, multi-problem, flexible, transdiagnostic intervention, the Common Elements Treatment Approach (CETA) in reducing (a) women’s experience of IPV and (b) their male partner’s alcohol misuse among couples in urban Zambia.

Methods and findings

This was a single-blind, parallel-assignment randomized controlled trial in Lusaka, Zambia. Women who reported moderate or higher levels of IPV and their male partners with hazardous alcohol use were enrolled as a couple and randomized to CETA or treatment as usual plus safety checks (TAU-Plus). The primary outcome, IPV, was assessed by the Severity of Violence Against Women Scale (SVAWS) physical/sexual violence subscale, and the secondary outcome, male alcohol misuse, by the Alcohol Use Disorders Identification Test (AUDIT). Assessors were blinded. Analyses were intent-to-treat. Primary outcome assessments were planned at post-treatment, 12 months post-baseline, and 24 months post-baseline. Enrollment was conducted between May 23, 2016, and December 17, 2016. In total, 123 couples were randomized to CETA, 125 to TAU-Plus. The majority of female (66%) and a plurality of male (48%) participants were between 18 and 35 years of age. Mean reduction in IPV (via SVAWS subscale score) at 12 months post-baseline was statistically significantly greater among women who received CETA compared to women who received TAU-Plus (−8.2, 95% CI −14.9 to −1.5, p = 0.02, Cohen’s d effect size = 0.49). Similarly, mean reduction in AUDIT score at 12 months post-baseline was statistically significantly greater among men who received CETA compared to men who received TAU (−4.5, 95% CI −6.9 to −2.2, p < 0.001, Cohen’s d effect size = 0.43). The Data and Safety Monitoring Board recommended the trial be stopped early due to treatment effectiveness following the 12-month post-baseline assessment, and CETA was offered to control participants. Limitations of the trial included the lack of a true control condition (i.e., that received no intervention), self-reported outcomes that may be subject to social desirability bias, and low statistical power for secondary IPV outcomes.

Conclusions

Results showed that CETA was more effective than TAU-Plus in reducing IPV and hazardous alcohol use among high-risk couples in Zambia. Future research and programming should include tertiary prevention approaches to IPV, such as CETA, rather than offering only community mobilization and primary prevention.

Trial registration

The trial was registered on ClinicalTrials.gov (NCT02790827).

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<![CDATA[Impact of law enforcement and increased traffic fines policy on road traffic fatality, injuries and offenses in Iran: Interrupted time series analysis]]> https://www.researchpad.co/article/N9254ca97-b759-40e9-8001-23227e05911a

Background

Road traffic law enforcement was implemented on 1st April 2011 (the first intervention) and traffic ticket fines have been increased on 1st March 2016 (the second intervention) in Iran. The aim of the current study was to evaluate the effects of the law enforcement on reduction in the incidence rate of road traffic fatality (IRRTF), the incidence rate of road traffic injuries (IRRTI) and the incidence rate of rural road traffic offenses (IRRRTO) in Iran.

Methods

Interrupted time series analysis was conducted to evaluate the impact of law enforcement and increased traffic tickets fines. Monthly data of fatality on urban, rural and local rural roads, injuries with respect to gender and traffic offenses namely speeding, illegal overtaking and tailgating were investigated separately for the period 2009–2016.

Results

Results showed a reduction in the incidence rate of total road traffic fatality (IRTRTF), the incidence rate of rural road traffic fatality (IRRRTF) and the incidence rate of urban road traffic fatality (IRURTF) by –21.44% (–39.3 to –3.59, 95% CI), –21.25% (–31.32 to –11.88, 95% CI) and –26.75% (–37.49 to –16, 95% CI) through the first intervention which resulted in 0.383, 0.255 and 0.222 decline in casualties per 100 000 population, respectively. Conversely, no reduction was found in the incidence rate of local rural road traffic fatality (IRLRRTF) and the IRRTI. Second intervention was found to only affect the IRURTF with –26.75% (–37.49 to –16, 95% CI) which led to 0.222 casualties per 100 000 population. In addition, a reduction effect was observed on the incidence rate of illegal overtaking (IRIO) and the incidence rate of speeding (IRS) with –42.8% (–57.39 to –28.22, 95% CI) and –10.54% (–21.05 to –0.03, 95% CI which implied a decrease of 415.85 and 1003.8 in monthly traffic offenses per 100 000 vehicles), respectively.

Conclusion

Time series analysis suggests a decline in IRTRTF, IRRRTF, and IRURTF caused by the first intervention. However, the second intervention found to be only effective in IRURTF, IRIO, and IRS with the implication that future initiatives should be focused on modifying the implementation of the traffic interventions.

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<![CDATA[Linking childhood emotional abuse and depressive symptoms: The role of emotion dysregulation and interpersonal problems]]> https://www.researchpad.co/article/5c6f149dd5eed0c48467a3fc

Childhood abuse is a major public health problem that has been linked to depression in adulthood. Although different types of childhood abuse often co-occur, few studies have examined their unique impact on negative mental health outcomes. Most studies have focused solely on the consequences of childhood physical or sexual abuse; however, it has been suggested that childhood emotional abuse is more strongly related to depression. It remains unclear which underlying psychological processes mediate the effect of childhood emotional abuse on depressive symptoms. In a cross-sectional study in 276 female college students, multiple linear regression analyses were used to determine whether childhood emotional abuse, physical abuse, and sexual abuse were independently associated with depressive symptoms, emotion dysregulation, and interpersonal problems. Subsequently, OLS regression analyses were used to determine whether emotion dysregulation and interpersonal problems mediate the relationship between childhood emotional abuse and depressive symptoms. Of all types of abuse, only emotional abuse was independently associated with depressive symptoms, emotion dysregulation, and interpersonal problems. The effect of childhood emotional abuse on depressive symptoms was mediated by emotion dysregulation and the following domains of interpersonal problems: cold/distant and domineering/controlling. The results of the current study indicate that detection and prevention of childhood emotional abuse deserves attention from Child Protective Services. Finally, interventions that target emotion regulation skills and interpersonal skills may be beneficial in prevention of depression.

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<![CDATA[White noise speech illusions in the general population: The association with psychosis expression and risk factors for psychosis]]> https://www.researchpad.co/article/5c76fe35d5eed0c484e5b70f

Introduction

Positive psychotic experiences are associated with increased rate of white noise speech illusions in patients and their relatives. However, findings have been conflicting to what degree speech illusions are associated with subclinical expression of psychosis in the general population. The aim of this study was to investigate the link between speech illusions and positive psychotic experiences in a general population sample. In addition, the hypothesis that speech illusions are on the pathway from known risk factors for psychosis (childhood adversity and recent life events) to subthreshold expression of psychosis, was examined.

Methods

In a follow-up design (baseline and 6 months) the association between the number of white noise speech illusions and self-reported psychotic experiences, assessed with the Community Assessment of Psychic Experiences (CAPE), was investigated in a general population sample (n = 112). In addition, associations between speech illusions and childhood adversity and life events, using the Childhood Experiences of Care and Abuse questionnaire and the Social Readjustment Rating Scale, were investigated.

Results

No association was found between the CAPE positive scale and the number of white noise speech illusions. The CAPE positive scale was significantly associated with childhood adversity between 12 and 16 years (B = 0.980 p = 0.001) and life events (B = 0.488 p = 0.044). The number of speech illusions showed no association with either life events or childhood adversity.

Conclusion

In the nonclinical population, the pathway from risk factors to expression of subclinical psychotic experiences does not involve white noise speech illusions as an intermediate outcome.

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<![CDATA[Identifying developmental trajectories of worldwide road traffic accident death rates using a latent growth mixture modeling approach]]> https://www.researchpad.co/article/5c76fe61d5eed0c484e5b9a7

Road Traffic Accidents (RTA) are a major worldwide public health problem. The aim of this study was to use the growth mixture model for clustering countries on the basis of the mortality rate patterns of RTAs from 2007 to 2013. We obtained the data on RTA death rates from World Health Organization reports and Human Development Index (HDI) of United Nations Development Programme reports for the years 2007, 2010 and 2013. Simple Latent Growth Models (LGM) in 181 countries were applied to estimate overall RTA mortality rate growth trajectories and the latent growth mixture modeling utilized to cluster them. According to non-linear LGM, the overall mortality rate of RTAs showed a decrease from 2007 to 2010 followed by an increase from 2010 to 2013. The HDI covariate had a significant negative and positive effect on intercept and slope of the LGM, respectively. The extracted mixture model appeared to have seven classes with different trends in RTA mortality rates. The worldwide countries were clustered into seven classes. Further studies on each of the seven classes are suggested to provide recommendations for reducing the mortality rate of the RTAs. Additionally, increasing HDI in some countries could have a significant effect on reducing the RTA death rates.

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<![CDATA[Violence against Afghan women by husbands, mothers-in-law and siblings-in-law/siblings: Risk markers and health consequences in an analysis of the baseline of a randomised controlled trial]]> https://www.researchpad.co/article/5c65dce9d5eed0c484dec55d

Background

Violence by mothers-in-law, as well as husbands, is a recognised problem in many countries. It has been given little attention in research on violence and its importance as a health problem, and aggravator of husband violence, has not been well established. Our aim was to describe patterns and the frequency of mother-in-law and sibling-in-law/sibling physical violence in relation to physical violence from husbands, and to describe risk characteristics and associated health behaviours of women with different abuse exposures.

Methods

1,463 women aged 18–48 were recruited into a randomised controlled trial (RCT) to evaluate a women empowerment intervention in 6 villages of Kabul and Nangarhar provinces. The women were interviewed at baseline. The analysis uses bi-variable and multivariable logistic regression.

Results

932 of the women were currently married. Of these, 14% of women experienced mother-in-law physical violence and 23.2% of women experienced physical spousal violence in the previous 12 months. For 7.0% of women, these exposures were combined. Physical violence was associated with food insecurity and having to borrow for food, being in a polygamous marriage, living with their mother-in-law, as well as province of residence (higher in Nangarhar). Women who had earnings were relatively protected. Whilst most mothers-in-law were described in positive terms, those who used physical violence were much less likely to be described so and a quarter were described as very strict and controlling and 16.8% as cruel. Overall slightly more women described their husband in positive terms than their mother-in-law, but there was a very strong correlation between the way in which husbands were perceived and the violence of their mothers.

Women’s mental health (depression, suicidal thoughts and PTSD symptoms score), self-rated general health, disability and beating of their children were all strongly associated with intimate partner violence (IPV) exposure. The strength of the association was much greater for all of these problems if the IPV was combined with physical violence from a mother-in-law or sibling-in-law/sibling. Experienced alone, violence from the mother-in-law or a sibling-in-law/sibling was associated with an elevated risk of all of these problems except depression.

Interpretation

Mother-in-law and sibling-in-law/sibling physical violence is an appreciable problem among the women studied in Afghanistan, linked to poverty. It has a major impact on women’s health, componding the heath impact of IPV. In this setting conceptualising women’s risk and exposure to violence at home as only in terms of IPV is inadequate and the framing of domestic violence much more appropriately captures women’s risks and exposures. We suggest that it may be fruitful for many women to target violence prevention at the domestic unit rather than just at women and their husbands.

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<![CDATA[Magnitude of road traffic accident related injuries and fatalities in Ethiopia]]> https://www.researchpad.co/article/5c59fea3d5eed0c4841351e4

Background

In many developing countries there is paucity of evidence regarding the epidemiology of road traffic accidents (RTAs). The study determines the rates of injuries and fatalities associated with RTAs in Ethiopia based on the data of a recent national survey.

Methods

The study is based on the secondary data of the Ethiopian Demographic and Health Survey conducted in 2016. The survey collected information about occurrence injuries and accidents including RTAs in the past 12 months among 75,271 members of 16,650 households. Households were selected from nine regions and two city administrations of Ethiopia using stratified cluster sampling procedure.

Results

Of the 75,271 household members enumerated, 123 encountered RTAs in the reference period and rate of RTA-related injury was 163 (95% confidence interval (CI): 136–195) per 100,000 population. Of the 123 causalities, 28 were fatal, making the fatality rate 37 (95% CI: 25–54) per 100,000 population. The RTA-related injuries and fatalities per 100,000 motor vehicles were estimated as 21,681 (95% CI: 18,090–25,938) and 4,922 (95% CI: 3325–7183), respectively. Next to accidental falls, RTAs were the second most common form of accidents and injuries accounting for 22.8% of all such incidents. RTAs contributed to 43.8% of all fatalities secondary to accidents and injuries. Among RTA causalities, 21.9% were drivers, 35.0% were passenger vehicle occupants and 36.0% were vulnerable road users including: motorcyclists (21.0%), pedestrians (12.1%) and cyclists (2.9%). Approximately half (47.1%) of the causalities were between 15–29 years of age and 15.3% were either minors younger than 15 years or seniors older than 64 years of age. Nearly two-thirds (65.0%) of the victims were males.

Conclusion

RTA-related causalities are extremely high in Ethiopia. Male young adults and vulnerable road users are at increased risk of RTAs. There is a urgent need for bringing road safety to the country's public health agenda.

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<![CDATA[Adolescent offenders' current whereabouts predict locations of their future crimes]]> https://www.researchpad.co/article/5c5b529fd5eed0c4842bcce5

Knowing where crime is likely to happen can help prevent it. Here I investigate whether two basic mechanisms of human mobility—preferential return and spatial exploration—explain and predict where offenders commit future crimes. A sample of 843 adolescents reported their hourly whereabouts during four days. In line with findings from other sources and populations, their locations were concentrated and predictable. During the subsequent four years, 70 of the 843 were apprehended for committing one or more crimes. Compared to others, these 70 future offenders had visited slightly more different locations. However, their action radius and the predictability of their whereabouts had been very similar to those who would not become offenders. The offenders perpetrated most of their crimes around places they had visited before, including places where they previously offended. These findings show that the predictability of human mobility applies to offending and to offenders as well, and helps us understand and forecast where they will commit future crimes. They may prove particularly useful in criminal investigations, as they suggest that police should generally prioritize suspects who are familiar with the location of the crime and its environs, either because of their legal routine activities or because of their prior offences.

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<![CDATA[Objective measures of rollator user stability and device loading during different walking scenarios]]> https://www.researchpad.co/article/5c5b5283d5eed0c4842bca5f

Walking aids are widely used by older adults, however, alarmingly, their use has been linked to increased falls-risk, yet clinicians have no objective way of assessing user stability. This work aims to demonstrate the application of a novel methodology to investigate how the type of walking task, the amount of body weight supported by the device (i.e., device loading), and task performance strategy affect stability of rollator users. In this context, ten users performed six walking tasks with an instrumented rollator. The combined stability margin “SM” was calculated, which considers user and rollator as a combined system. A Friedman Test was used to investigate the effects of task on SM and a least-squares regression model was applied to investigate the relationship between device loading and SM. In addition, the effects of task performance strategy on SM were explored. As a result, it was found that: the minimum SM for straight line walking was higher than for more complex tasks (p<0.05); an increase in device loading was associated with an increase in SM (p<0.05); stepping up a kerb with at least 1 rollator wheel in ground contact at all times resulted in higher SM than lifting all four wheels simultaneously. Hence, we conclude that training should not be limited to straight line walking but should include various everyday tasks. Within person, SM informs on which tasks need practicing, and which strategy facilitates stability, thereby enabling person-specific guidance/training. The relevance of this work lies in an increase in walking aid users, and the costs arising from fall-related injuries.

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<![CDATA[Vulnerability of cotton subjected to hail damage]]> https://www.researchpad.co/article/5c5b528ed5eed0c4842bcb6d

This paper establishes the quantitative relationships between hail fall parameters and crop damages by examining the impacts of 49 hail hazard scenarios on cotton in the bud stage and boll stage. This study utilizes simulated cotton hail hazard to analyze the following data: hail size, hail fall density, and crop damages (i.e., defoliation rate, branch breaking rate, and the fruit falling rate). The results are as follows: 1) cotton vulnerability increased via an increase in crop damages as the hail hazard magnitude increased; 2) crop damages exhibit significant logistic relationships with hail diameter and hail fall density, and the fit was better at the bud stage than at the boll stage; 3) cotton is more vulnerable to hail hazard at the bud stage than at the boll stage, and the bud stage is a critical period for cotton hail disaster prevention and mitigation; and 4) damages to cotton plant at the bud stage and boll stage were less sensitive to hail size from hail fall density. Thus, we suggest that hail diameter can be used as the priority indicator to predict hail-induced crop damages. These results provide a sound basis for developing a comprehensive evaluation of hail damage in cotton, which is crucial for promoting sustainable cotton production. We recommend that the impacts of hail-induced crop damages on yield and fiber quality need to be addressed further in future studies.

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<![CDATA[Correlated impulses: Using Facebook interests to improve predictions of crime rates in urban areas]]> https://www.researchpad.co/article/5c61e910d5eed0c48496f765

Much research has examined how crime rates vary across urban neighborhoods, focusing particularly on community-level demographic and social characteristics. A parallel line of work has treated crime at the individual level as an expression of certain behavioral patterns (e.g., impulsivity). Little work has considered, however, whether the prevalence of such behavioral patterns in a neighborhood might be predictive of local crime, in large part because such measures are hard to come by and often subjective. The Facebook Advertising API offers a special opportunity to examine this question as it provides an extensive list of “interests” that can be tabulated at various geographic scales. Here we conduct an analysis of the association between the prevalence of interests among the Facebook population of a ZIP code and the local rate of assaults, burglaries, and robberies across 9 highly populated cities in the US. We fit various regression models to predict crime rates as a function of the Facebook and census demographic variables. In general, models using the variables for the interests of the whole adult population on Facebook perform better than those using data on specific demographic groups (such as Males 18-34). In terms of predictive performance, models combining Facebook data with demographic data generally have lower error rates than models using only demographic data. We find that interests associated with media consumption and mating competition are predictive of crime rates above and beyond demographic factors. We discuss how this might integrate with existing criminological theory.

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<![CDATA[Readmission risk and costs of firearm injuries in the United States, 2010-2015]]> https://www.researchpad.co/article/5c536c37d5eed0c484a49bcc

Background

In 2015 there were 36,252 firearm-related deaths and 84,997 nonfatal injuries in the United States. The longitudinal burden of these injuries through readmissions is currently underestimated. We aimed to determine the 6-month readmission risk and hospital costs for patients injured by firearms.

Methods

We used the Nationwide Readmission Database 2010–2015 to assess the frequency of readmissions at 6 months, and hospital costs associated with readmissions for patients with firearm-related injuries. We produced nationally representative estimates of readmission risks and costs.

Results

Of patients discharged following a firearm injury, 15.6% were readmitted within 6 months. The average annual cost of inpatient hospitalizations for firearm injury was over $911 million, 9.5% of which was due to readmissions. Medicare and Medicaid covered 45.2% of total costs for the 5 years, and uninsured patients were responsible for 20.1%.

Conclusions

From 2010–2015, the average total cost of hospitalization for firearm injuries per patient was $32,700, almost 10% of which was due to readmissions within 6 months. Government insurance programs and the uninsured shouldered most of this.

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<![CDATA[Trauma induced acute kidney injury]]> https://www.researchpad.co/article/5c57e693d5eed0c484ef37fb

Background

Injured patients are at risk of developing acute kidney injury (AKI), which is associated with increased morbidity and mortality. The aim of this study is to describe the incidence, timing, and severity of AKI in a large trauma population, identify risk factors for AKI, and report mortality outcomes.

Methods

A prospective observational study of injured adults, who met local criteria for trauma team activation, and were admitted to a UK Major Trauma Centre. AKI was defined by the Kidney Disease Improving Global Outcomes (KDIGO) criteria. Multivariable logistic regression and Cox proportional hazard modelling was used to analyse parameters associated with AKI and mortality.

Results

Of the 1410 patients enrolled in the study, 178 (12.6%) developed AKI. Age; injury severity score (ISS); admission systolic blood pressure, lactate and serum creatinine; units of Packed Red Blood Cells transfused in first 24 hours and administration of nephrotoxic therapy were identified as independent risk factors for the development of AKI. Patients that developed AKI had significantly higher mortality than those with normal renal function (47/178 [26.4%] versus 128/1232 [10.4%]; OR 3.09 [2.12 to 4.53]; p<0.0001). After adjusting for other clinical prognostic factors, AKI was an independent risk factor for mortality.

Conclusions

AKI is a frequent complication following trauma and is associated with prolonged hospital length of stay and increased mortality. Future research is needed to improve our ability to rapidly identify those at risk of AKI, and develop resuscitation strategies that preserve renal function in trauma patients.

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<![CDATA[Context for layering women’s nutrition interventions on a large scale poverty alleviation program: Evidence from three eastern Indian states]]> https://www.researchpad.co/article/5c50c47dd5eed0c4845e881d

Over 70 million women of reproductive age are undernourished in India. Most poverty alleviation programs have not been systematically evaluated to assess impact on women’s empowerment and nutrition outcomes. National Rural Livelihoods Mission’s poverty alleviation and livelihoods generation initiative is an opportune platform to layer women’s nutrition interventions being tapped by project Swabhimaan in three eastern Indian states—Bihar, Chhattisgarh and Odisha. A cross-sectional baseline survey covering 8755 mothers of children under-two years of age, one of the three primary target groups of program are presented. Standardized questionnaire was administered and anthropometric measurements were undertaken from October 2016 to January 2017. 21 indicators on women’s empowerment, Body Mass Index and Mid-upper Arm Circumference for nutrition status, food insecurity indicators as per the Food Insecurity Experience Scale and selected indicators for assessing women’s access to basic health services were included. National Rural Livelihoods Mission operates in contexts with stark social and gender inequalities. Self-help group members exhibited better control on financial resources and participation in community activities than non-members. Using Body Mass Index, at least 45% mothers were undernourished irrespective of their enrolment in self-help groups. Higher proportion of self-help group members (77%-87%) belonged to food insecure households than non-members (66%-83%). Proportion of mothers reporting receipt of various components of antenatal care service package varied from over 90% for tetanus toxoid vaccination to less than 10% for height measurement. Current use of family planning methods was excruciatingly low (8.2%-32.4%) in all states but positively skewed towards self-help group members. Participation in monthly fixed day health camps was a concern in Bihar. Layering women’s nutrition interventions as stipulated under Swabhimaan may yield better results for women’s empowerment and nutrition status under National Rural Livelihoods Mission. While this opportunity exists in all three states, Bihar with a higher proportion of matured self-help groups offers more readiness for Swabhimaan implementation.

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<![CDATA[Negative mood induction: Affective reactivity in recurrent, but not persistent depression]]> https://www.researchpad.co/article/5c478c6fd5eed0c484bd24e8

Background

Despite the high clinical and epidemiological relevance of persistent depression, little is known about its specific psychopathology and whether it is distinct from recurrent depression. Depression in general has been associated with blunted affective reactivity but the evidence from previous studies is inconsistent. Here, we asked whether affective reactivity might differ between persistent and recurrent depression.

Methods

Twenty patients with persistent depression, 20 patients with recurrent depression and 20 healthy controls (HC) were recruited. Both patient groups showed moderate symptom severity. All participants underwent a sad mood induction procedure. Affective reactivity was assessed with the Positive and Negative Affect Schedule (PANAS) before and after mood induction.

Results

We found a striking difference in affective reactivity between patient groups. While the persistent group showed blunted reactivity to mood induction, the recurrent group demonstrated an affective response that was comparable to HC, with an increase in negative and a decrease in positive affect. Blunted affective reactivity was thus specifically associated with persistent in contrast to recurrent depression.

Conclusions

These results highlight affective reactivity as an important psychopathological feature that differs between the two patient groups. Preserved affective reactivity to emotional stimuli in the recurrent group might reflect a resilience factor against persistence of depression.

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<![CDATA[Epidemiology of low-energy lower extremity fracture in Chinese populations aged 50 years and above]]> https://www.researchpad.co/article/5c46657fd5eed0c484519799

This study aimed to investigate the epidemiology of low-energy lower-extremity fracture in Chinese men and women aged 50 years and above. This study was a part of Chinese National Fracture Survey (CNFS), which used the stratified multistage cluster random sampling method to recruit subjects between January and May 2015. A total of 512187 individuals participated in the CNFS and of them there were 154099 men and women aged 50 years and above included in this study for data analysis. Low-energy fracture was defined as a fracture caused by slip, trip or fall from standing height. Univariate analyses and gender-based multivariate logistic regression models were constructed to identify the independent risk factors. A total of 215 patients had sustained low-energy lower extremity fractures in 2014, indicating the overall incidence was 139.5 (120.9 to 158.2) per 100000 persons, with 127.8 (102.5 to 153.1) and 151.1 (123.8 to 178.5) per 100000 person-year in men and women. Over 80% of fractures occurred at home and on the common road. In men, alcohol consumption (OR, 2.00; 95%CI, 1.29 to 3.08), sleep duration<7h/d (OR, 2.60; 95%CI, 1.68 to 4.03) and history of past fracture (OR, 2.57; 95%CI, 1.33 to 4.95) were identified as significant risk factors associated with low-energy fractures. In women, advanced age (80+ years) (OR, 3.22; 95%CI, 1.80 to 5.75), alcohol consumption(OR, 1.72; 95%CI, 1.00 to 2.98), sleep duration <7h/d (OR, 2.11; 95%CI, 1.40 to 3.18), and history of past fracture (OR, 3.46; 95%CI, 1.97 to 6.09) were identified as significant risk factors and living in western region (OR, 0.60; 95%CI, 0.38 to 0.94) and current weight of 50 to 59.9 kg (OR, 0.17; 95%CI, 0.04 to 0.73) were identified as protective factors for fractures. Accordingly, awareness on the importance of sleep and alcohol consumption on fragility fracture should be improved, and health policies that focus on decreasing alcohol consumption and encouraging individuals to improve their sleep quality and duration should be considered. Maintaining a healthy bodyweight for women should be specifically emphasized to prevent low-energy fractures.

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<![CDATA[Are we validly assessing major depression disorder risk and associated factors among mothers of young children? A cross-sectional study involving home visitation programs]]> https://www.researchpad.co/article/5c3d0182d5eed0c48403c018

Failure to account for misclassification error accruing from imperfect case-finding instruments can produce biased estimates of suspected major depression disorder (MDD) risk factor associations. The objective of this study was to estimate the impact of misclassification error on the magnitude of measures of association between suspected risk factors and MDD assessed using the Center of Epidemiological Studies on Depression—Short Form during the prenatal and postnatal periods. Baseline data were collected from 520 mothers participating in two home visitation studies in Oklahoma City between 2010 and 2014. A Bayesian binomial latent class model was used to compare the prevalence proportion ratio (PPR) between suspected risk factors and MDD with and without adjustment for misclassification error and confounding by period of MDD symptom on-set. Adjustment for misclassification error and confounding by period of MDD on-set (prenatal vs postnatal) showed that the association between suspected risk factors and MDD is underestimated (-) and overestimated (+) differentially in different source populations of low-income mothers. The median bias in the magnitude of PPR estimates ranged between -.47 (95% Bayesian Credible Intervals [BCI]: -10.67, 1.90) for intimate partner violence to +.06 (95%BCI: -0.37, 0.47) for race/ethnicity among native-born US residents. Among recent Hispanic immigrants, bias ranged from -.77 (95%BCI: -15.31, 0.96) for history of childhood maltreatment to +.10 (95%BCI: -0.17, 0.39) for adequacy of family resources. Overall, the extent of bias on measures of association between maternal MDD and suspected risk factors is considerable without adjustment for misclassification error and is even higher for confounding by period of MDD assessment. Consideration of these biases in MDD prevention research is warranted.

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<![CDATA[Does a history of sexual and physical childhood abuse contribute to HIV infection risk in adulthood? A study among post-natal women in Harare, Zimbabwe]]> https://www.researchpad.co/article/5c390bb2d5eed0c48491ddfa

Background

Sexual and physical abuse in childhood creates a great health burden including on mental and reproductive health. A possible link between child abuse and HIV infection has increasingly attracted attention. This paper investigated whether a history of child physical and sexual abuse is associated with HIV infection among adult women.

Methods

A cross sectional survey was conducted among 2042 postnatal women (mean age = 26y) attending six public primary health care clinics in Harare, Zimbabwe within 6 weeks post-delivery. Clinic records were reviewed for mother’s antenatal HIV status. Participants were interviewed about childhood abuse including physical or sexual abuse before 15 years of age, forced first sex before 16, HIV risk factors such as age difference at first sex before age 16. Multivariate analyses assessed the associations between mother’s HIV status and child physical and sexual abuse while controlling for confounding variables.

Results

More than one in four (26.6%) reported abuse before the age of 15: 14.6% physical abuse and 9.1% sexual abuse,14.3% reported forced first sex and 9.0% first sex before 16 with someone 5+ years older. Fifteen percent of women tested HIV positive during the recent antenatal care visit. In multivariate analysis, childhood physical abuse (aOR 3.30 95%CI 1.58–6.90), sexual abuse (3.18 95%CI: 1.64–6.19), forced first sex (aOR 1.42, 95%CI: 1.00–2.02), and 5+ years age difference with first sex partner (aOR 1.66 95%CI 1.09–2.53) were independently associated with HIV infection.

Conclusion

This study highlights that child physical and/or sexual abuse may increase risk for HIV acquisition. Further research is needed to assess the pathways to HIV acquisition from childhood to adulthood. Prevention of child abuse must form part of the HIV prevention agenda in Sub-Saharan Africa.

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