Paediatrics (RCH) - Research Publications

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    World Health Organization and knowledge translation in maternal, newborn, child and adolescent health and nutrition
    Duke, T ; AlBuhairan, FS ; Agarwal, K ; Arora, NK ; Arulkumaran, S ; Bhutta, ZA ; Binka, F ; Castro, A ; Claeson, M ; Dao, B ; Darmstadt, GL ; English, M ; Jardali, F ; Merson, M ; Ferrand, RA ; Golden, A ; Golden, MH ; Homer, C ; Jehan, F ; Kabiru, CW ; Kirkwood, B ; Lawn, JE ; Li, S ; Patton, GC ; Ruel, M ; Sandall, J ; Sachdev, HS ; Tomlinson, M ; Waiswa, P ; Walker, D ; Zlotkin, S (BMJ PUBLISHING GROUP, 2021-12-28)
    The World Health Organization (WHO) has a mandate to promote maternal and child health and welfare through support to governments in the form of technical assistance, standards, epidemiological and statistical services, promoting teaching and training of healthcare professionals and providing direct aid in emergencies. The Strategic and Technical Advisory Group of Experts (STAGE) for maternal, newborn, child and adolescent health and nutrition (MNCAHN) was established in 2020 to advise the Director-General of WHO on issues relating to MNCAHN. STAGE comprises individuals from multiple low-income and middle-income and high-income countries, has representatives from many professional disciplines and with diverse experience and interests.Progress in MNCAHN requires improvements in quality of services, equity of access and the evolution of services as technical guidance, community needs and epidemiology changes. Knowledge translation of WHO guidance and other guidelines is an important part of this. Countries need effective and responsive structures for adaptation and implementation of evidence-based interventions, strategies to improve guideline uptake, education and training and mechanisms to monitor quality and safety. This paper summarises STAGE's recommendations on how to improve knowledge translation in MNCAHN. They include support for national and regional technical advisory groups and subnational committees that coordinate maternal and child health; support for national plans for MNCAHN and their implementation and monitoring; the production of a small number of consolidated MNCAHN guidelines to promote integrated and holistic care; education and quality improvement strategies to support guidelines uptake; monitoring of gaps in knowledge translation and operational research in MNCAHN.
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    International consensus on a standard set of outcome measures for child and youth anxiety, depression, obsessive-compulsive disorder, and post-traumatic stress disorder
    Krause, KR ; Chung, S ; Adewuya, AO ; Albano, AM ; Babins-Wagner, R ; Birkinshaw, L ; Brann, P ; Creswell, C ; Delaney, K ; Falissard, B ; Forrest, CB ; Hudson, JL ; Ishikawa, S-I ; Khatwani, M ; Kieling, C ; Krause, J ; Malik, K ; Martinez, V ; Mughal, F ; Ollendick, TH ; Ong, SH ; Patton, GC ; Ravens-Sieberer, U ; Szatmari, P ; Thomas, E ; Walters, L ; Young, B ; Zhao, Y ; Wolpert, M (ELSEVIER SCI LTD, 2021-01-01)
    A major barrier to improving care effectiveness for mental health is a lack of consensus on outcomes measurement. The International Consortium for Health Outcomes Measurement (ICHOM) has already developed a consensus-based standard set of outcomes for anxiety and depression in adults (including the Patient Health Questionnaire-9, the Generalised Anxiety Disorder 7-item Scale, and the WHO Disability Schedule). This Position Paper reports on recommendations specifically for anxiety, depression, obsessive-compulsive disorder, and post-traumatic stress disorder in children and young people aged between 6 and 24 years. An international ICHOM working group of 27 clinical, research, and lived experience experts formed a consensus through teleconferences, an exercise using an adapted Delphi technique (a method for reaching group consensus), and iterative anonymous voting, supported by sequential research inputs. A systematic scoping review identified 70 possible outcomes and 107 relevant measurement instruments. Measures were appraised for their feasibility in routine practice (ie, brevity, free availability, validation in children and young people, and language translation) and psychometric performance (ie, validity, reliability, and sensitivity to change). The final standard set recommends tracking symptoms, suicidal thoughts and behaviour, and functioning as a minimum through seven primarily patient-reported outcome measures: the Revised Children's Anxiety and Depression Scale, the Obsessive Compulsive Inventory for Children, the Children's Revised Impact of Events Scale, the Columbia Suicide Severity Rating Scale, the KIDSCREEN-10, the Children's Global Assessment Scale, and the Child Anxiety Life Interference Scale. The set's recommendations were validated through a feedback survey involving 487 participants across 45 countries. The set should be used alongside the anxiety and depression standard set for adults with clinicians selecting age-appropriate measures.
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    Coverage of school health monitoring systems in China: a large national cross-sectional survey
    Yan, X ; Hu, P ; Ma, N ; Luo, D ; Zhang, J ; Wang, J ; Dong, Y ; Xing, Y ; Song, Y ; Ma, J ; Patton, GC ; Sawyer, SM (ELSEVIER, 2022-02-01)
    BACKGROUND: There is growing interest in the role that schools can play in promoting student health. The aim of this study was to describe the coverage of school health monitoring systems for infectious diseases, non-communicable diseases, and school physical environments in China, and to explore differences by geography, regional wealth, and school type. METHODS: A cross-sectional study was performed using data from 2428 schools from 17 provinces in China in 2018. Data were collected using a questionnaire administered by the Ministry of Education through its monitoring system, and included infectious diseases (e.g., reporting system for student infectious diseases), non-communicable diseases (e.g., regular student health examinations), and school physical environments (e.g., monitoring of classroom light, microclimate and drinking water). FINDINGS: Overall, the coverage rate of full school health monitoring systems was 16·6%. The coverage rates of school health monitoring systems for infectious diseases, non-communicable diseases, and school physical environments were 71·2%, 68·5%, and 24·9%, respectively. Coverage was higher in schools from urban rather than rural areas, in schools from areas with greater wealth, and in senior secondary schools rather than junior secondary and primary schools. INTERPRETATION: Systems for monitoring infectious diseases in school students have been widely implemented in China. Systems for monitoring non-communicable diseases and physical environments need to be strengthened. Beyond greater attention in poorer and rural areas, increased investment in more comprehensive approaches to school health is indicated. FUNDING: This study was supported by National Statistical Science Research Project (2021LY052 to YS) and China Scholarship Council (201906015028 to PH).
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    Global, regional, and national mortality among young people aged 10-24 years, 1950-2019: a systematic analysis for the Global Burden of Disease Study 2019
    Ward, JL ; Azzopardi, PS ; Francis, KL ; Santelli, JS ; Skirbekk, V ; Sawyer, SM ; Kassebaum, NJ ; Mokdad, AH ; Hay, SI ; Abd-Allah, F ; Abdoli, A ; Abdollahi, M ; Abedi, A ; Abolhassani, H ; Abreu, LG ; Abrigo, MRM ; Abu-Gharbieh, E ; Abushouk, AI ; Adebayo, OM ; Adekanmbi, V ; Adham, D ; Advani, SM ; Afshari, K ; Agrawal, A ; Ahmad, T ; Ahmadi, K ; Ahmed, AE ; Aji, B ; Akombi-Inyang, B ; Alahdab, F ; Al-Aly, Z ; Alam, K ; Alanezi, FM ; Alanzi, TM ; Alcalde-Rabanal, JE ; Alemu, BW ; Al-Hajj, S ; Alhassan, RK ; Ali, S ; Alicandro, G ; Alijanzadeh, M ; Aljunid, SM ; Almasi-Hashiani, A ; Almasri, NA ; Al-Mekhlafi, HM ; Alonso, J ; Al-Raddadi, RM ; Altirkawi, KA ; Alvis-Guzman, N ; Amare, AT ; Amini, S ; Aminorroaya, A ; Amit, AML ; Amugsi, DA ; Ancuceanu, R ; Anderlini, D ; Andrei, CL ; Androudi, S ; Ansari, F ; Ansari, I ; Antonio, CAT ; Anvari, D ; Anwer, R ; Appiah, SCY ; Arabloo, J ; Arab-Zozani, M ; Arnlov, J ; Asaad, M ; Asadi-Aliabadi, M ; Asadi-Pooya, AA ; Atout, MMW ; Ausloos, M ; Avenyo, EK ; Avila-Burgos, L ; Quintanilla, BPA ; Ayano, G ; Aynalem, YA ; Azari, S ; Azene, ZN ; Bakhshaei, MH ; Bakkannavar, SM ; Banach, M ; Banik, PC ; Barboza, MA ; Barker-Collo, SL ; Baernighausen, TW ; Basu, S ; Baune, BT ; Bayati, M ; Bedi, N ; Beghi, E ; Bekuma, TT ; Bell, AW ; Bell, ML ; Benjet, C ; Bensenor, IM ; Berhe, AK ; Berhe, K ; Berman, AE ; Bhagavathula, AS ; Bhardwaj, N ; Bhardwaj, P ; Bhattacharyya, K ; Bhattarai, S ; Bhutta, ZA ; Bijani, A ; Bikbov, B ; Biondi, A ; Birhanu, TTM ; Biswas, RK ; Bohlouli, S ; Bolla, SR ; Boloor, A ; Borschmann, R ; Boufous, S ; Bragazzi, NL ; Braithwaite, D ; Breitborde, NJK ; Brenner, H ; Britton, GB ; Burns, RA ; Nagaraja, SB ; Butt, ZA ; dos Santos, FLC ; Camera, LA ; Campos-Nonato, IR ; Campuzano Rincon, JC ; Cardenas, R ; Carreras, G ; Carrero, JJ ; Carvalho, F ; Castaldelli-Maia, JM ; Castaneda-Orjuela, CA ; Castelpietra, G ; Catala-Lopez, F ; Cerin, E ; Chandan, JS ; Chang, H-Y ; Chang, J-C ; Charan, J ; Chattu, VK ; Chaturvedi, S ; Choi, J-YJ ; Chowdhury, MAK ; Christopher, DJ ; Dinh-Toi, C ; Chung, MT ; Chung, S-C ; Cicuttini, FM ; Constantin, TV ; Costa, VM ; Dahlawi, SMA ; Dai, H ; Dai, X ; Damiani, G ; Dandona, L ; Dandona, R ; Daneshpajouhnejad, P ; Darwesh, AM ; Alberto Davila-Cervantes, C ; Davletov, K ; De la Hoz, FP ; De Leo, D ; Dervenis, N ; Desai, R ; Desalew, A ; Deuba, K ; Dharmaratne, SD ; Dhungana, GP ; Dianatinasab, M ; da Silva, DD ; Diaz, D ; Didarloo, A ; Djalalinia, S ; Dorostkar, F ; Doshi, CP ; Doshmangir, L ; Doyle, KE ; Duraes, AR ; Kalan, ME ; Ebtehaj, S ; Edvardsson, D ; El Tantawi, M ; Elgendy, IY ; El-Jaafary, SI ; Elsharkawy, A ; Eshrati, B ; Eskandarieh, S ; Esmaeilnejad, S ; Esmaeilzadeh, F ; Esteghamati, S ; Faro, A ; Farzadfar, F ; Fattahi, N ; Feigin, VL ; Ferede, TY ; Fereshtehnejad, S-M ; Fernandes, E ; Ferrara, P ; Filip, I ; Fischer, F ; Fisher, JL ; Foigt, NA ; Folayan, MO ; Fomenkov, AA ; Foroutan, M ; Fukumoto, T ; Gad, MM ; Gaidhane, AM ; Gallus, S ; Gebre, T ; Gebremedhin, KB ; Gebremeskel, GG ; Gebremeskel, L ; Gebreslassie, AA ; Gesesew, HA ; Ghadiri, K ; Ghafourifard, M ; Ghamari, F ; Ghashghaee, A ; Gilani, SA ; Gnedovskaya, EV ; Godinho, MA ; Golechha, M ; Goli, S ; Gona, PN ; Gopalani, SV ; Gorini, G ; Grivna, M ; Gubari, MIM ; Gugnani, HC ; Guimaraes, RA ; Guo, Y ; Gupta, R ; Haagsma, JA ; Hafezi-Nejad, N ; Haile, TG ; Haj-Mirzaian, A ; Haj-Mirzaian, A ; Hall, BJ ; Hamadeh, RR ; Abdullah, KH ; Hamidi, S ; Handiso, DW ; Hanif, A ; Hankey, GJ ; Haririan, H ; Maria Haro, J ; Hasaballah, AI ; Hashi, A ; Hassan, A ; Hassanipour, S ; Hassankhani, H ; Hayat, K ; Heidari-Soureshjani, R ; Herteliu, C ; Heydarpour, F ; Ho, HC ; Hole, MK ; Holla, R ; Hoogar, P ; Hosseini, M ; Hosseinzadeh, M ; Hostiuc, M ; Hostiuc, S ; Househ, M ; Hsairi, M ; Huda, TM ; Humayun, A ; Hussain, R ; Hwang, B-F ; Iavicoli, I ; Ibitoye, SE ; Ilesanmi, OS ; Ilic, IM ; Ilic, MD ; Inbaraj, LR ; Intarut, N ; Iqbal, U ; Irvani, SSN ; Islam, MM ; Islam, SMS ; Iso, H ; Ivers, RQ ; Jahani, MA ; Jakovljevic, M ; Jalali, A ; Janodia, MD ; Javaheri, T ; Jeemon, P ; Jenabi, E ; Jha, RP ; Jha, V ; Ji, JS ; Jonas, JB ; Jones, KM ; Joukar, F ; Jozwiak, JJ ; Juliusson, PB ; Jurisson, M ; Kabir, A ; Kabir, Z ; Kalankesh, LR ; Kalhor, R ; Kamyari, N ; Kanchan, T ; Karch, A ; Karimi, SE ; Kaur, S ; Kayode, GA ; Keiyoro, PN ; Khalid, N ; Khammarnia, M ; Khan, M ; Khan, MN ; Khatab, K ; Khater, MM ; Khatib, MN ; Khayamzadeh, M ; Khazaie, H ; Khoja, AT ; Kieling, C ; Kim, Y-E ; Kim, YJ ; Kimokoti, RW ; Kisa, A ; Kisa, S ; Kivimaki, M ; Koolivand, A ; Kosen, S ; Koyanagi, A ; Krishan, K ; Kugbey, N ; Kumar, GA ; Kumar, M ; Kumar, N ; Kurmi, OP ; Kusuma, D ; La Vecchia, C ; Lacey, B ; Lal, DK ; Lalloo, R ; Lan, Q ; Landires, I ; Lansingh, VC ; Larsson, AO ; Lasrado, S ; Lassi, ZS ; Lauriola, P ; Lee, PH ; Lee, SWH ; Leigh, J ; Leonardi, M ; Leung, J ; Levi, M ; Lewycka, S ; Li, B ; Li, M-C ; Li, S ; Lim, L-L ; Lim, SS ; Liu, X ; Lorkowski, S ; Lotufo, PA ; Lunevicius, R ; Maddison, R ; Mahasha, PW ; Mahdavi, MM ; Mahmoudi, M ; Majeed, A ; Maleki, A ; Malekzadeh, R ; Malta, DC ; Mamun, AA ; Mansouri, B ; Mansournia, MA ; Martinez, G ; Martinez-Raga, J ; Martins-Melo, FR ; Mason-Jones, AJ ; Masoumi, SZ ; Mathur, MR ; Maulik, PK ; McGrath, JJ ; Mehndiratta, MM ; Mehri, F ; Memiah, PTN ; Mendoza, W ; Menezes, RG ; Mengesha, EW ; Meretoja, A ; Meretoja, TJ ; Mestrovic, T ; Miazgowski, B ; Miazgowski, T ; Michalek, IM ; Miller, TR ; Mini, GK ; Mirica, A ; Mirrakhimov, EM ; Mirzaei, H ; Mirzaei, M ; Moazen, B ; Mohammad, DK ; Mohammadi, S ; Mohammadian-Hafshejani, A ; Mohammadifard, N ; Mohammadpourhodki, R ; Mohammed, S ; Monasta, L ; Moradi, G ; Moradi-Lakeh, M ; Moradzadeh, R ; Moraga, P ; Morrison, SD ; Mosapour, A ; Khaneghah, AM ; Mueller, UO ; Muriithi, MK ; Murray, CJL ; Muthupandian, S ; Naderi, M ; Nagarajan, AJ ; Naghavi, M ; Naimzada, MD ; Nangia, V ; Nayak, VC ; Nazari, J ; Ndejjo, R ; Negoi, I ; Negoi, RI ; Netsere, HB ; Nguefack-Tsague, G ; Diep, NN ; Huong, LTN ; Nie, J ; Ningrum, DNA ; Nnaji, CA ; Nomura, S ; Noubiap, JJ ; Nowak, C ; Nunez-Samudio, V ; Ogbo, FA ; Oghenetega, OB ; Oh, I-H ; Oladnabi, M ; Olagunju, AT ; Olusanya, BO ; Olusanya, JO ; Bali, AO ; Omer, MO ; Onwujekwe, OE ; Ortiz, A ; Otoiu, A ; Otstavnov, N ; Otstavnov, SS ; Overland, S ; Owolabi, MO ; Mahesh, PA ; Padubidri, JR ; Pakshir, K ; Palladino, R ; Pana, A ; Panda-Jonas, S ; Pandey, A ; Able Panelo, CI ; Park, E-K ; Patten, SB ; Peden, AE ; Filipino Pepito, VC ; Peprah, EK ; Pereira, J ; Pesudovs, K ; Hai, QP ; Phillips, MR ; Piradov, MA ; Pirsaheb, M ; Postma, MJ ; Pottoo, FH ; Pourjafar, H ; Pourshams, A ; Prada, SI ; Pupillo, E ; Syed, ZQ ; Rabiee, MH ; Rabiee, N ; Radfar, A ; Rafiee, A ; Raggi, A ; Rahim, F ; Rahimi-Movaghar, V ; Rahman, MHU ; Rahman, MA ; Ramezanzadeh, K ; Ranabhat, CL ; Rao, SJ ; Rashedi, V ; Rastogi, P ; Rathi, P ; Rawaf, DL ; Rawaf, S ; Rawal, L ; Rawassizadeh, R ; Renzaho, AMN ; Rezaei, N ; Rezaei, N ; Rezai, MS ; Riahi, SM ; Rickard, J ; Roever, L ; Ronfani, L ; Roth, GA ; Rubagotti, E ; Rumisha, SF ; Rwegerera, GM ; Sabour, S ; Sachdev, PS ; Saddik, B ; Sadeghi, E ; Moghaddam, SS ; Sagar, R ; Sahebkar, A ; Sahraian, MA ; Sajadi, SM ; Salem, MR ; Salimzadeh, H ; Samy, AM ; Sanabria, J ; Santric-Milicevic, MM ; Saraswathy, SYI ; Sarrafzadegan, N ; Sarveazad, A ; Sathish, T ; Sattin, D ; Saxena, D ; Saxena, S ; Schiavolin, S ; Schwebel, DC ; Schwendicke, F ; Senthilkumaran, S ; Sepanlou, SG ; Sha, F ; Shafaat, O ; Shahabi, S ; Shaheen, AA ; Shaikh, MA ; Shakiba, S ; Shamsi, MB ; Shannawaz, M ; Sharafi, K ; Sheikh, A ; Sheikhbahaei, S ; Shetty, BSK ; Shi, P ; Shigematsu, M ; Shin, JI ; Shiri, R ; Shuval, K ; Siabani, S ; Sigfusdottir, ID ; Sigurvinsdottir, R ; Santos Silva, DA ; Silva, JP ; Simonetti, B ; Singh, JA ; Singh, V ; Sinke, AH ; Skryabin, VY ; Slater, H ; Smith, EUR ; Sobhiyeh, MR ; Sobngwi, E ; Soheili, A ; Somefun, OD ; Sorrie, MB ; Soyiri, IN ; Sreeramareddy, CT ; Stein, DJ ; Stokes, MA ; Sudaryanto, A ; Sultan, I ; Tabares-Seisdedos, R ; Tabuchi, T ; Tadakamadla, SK ; Taherkhani, A ; Tamiru, AT ; Tareque, MI ; Thankappan, KR ; Thapar, R ; Thomas, N ; Titova, MV ; Tonelli, M ; Tovani-Palone, MR ; Bach, XT ; Travillian, RS ; Tsai, AC ; Tsatsakis, A ; Car, LT ; Uddin, R ; Unim, B ; Unnikrishnan, B ; Upadhyay, E ; Vacante, M ; Tahbaz, SV ; Valdez, PR ; Varughese, S ; Vasankari, TJ ; Venketasubramanian, N ; Villeneuve, PJ ; Violante, FS ; Vlassov, V ; Vos, T ; Giang, TV ; Waheed, Y ; Wamai, RG ; Wang, Y ; Wang, Y ; Wang, Y-P ; Westerman, R ; Wickramasinghe, ND ; Wu, A-M ; Wu, C ; Jabbari, SHY ; Yamagishi, K ; Yano, Y ; Yaya, S ; Yazdi-Feyzabadi, V ; Yeshitila, YG ; Yip, P ; Yonemoto, N ; Yoon, S-J ; Younis, MZ ; Yousefinezhadi, T ; Yu, C ; Yu, Y ; Yuce, D ; Zaidi, SS ; Bin Zaman, S ; Zamani, M ; Zamanian, M ; Zarafshan, H ; Zarei, A ; Zastrozhin, MS ; Zhang, Y ; Zhang, Z-J ; Zhao, X-JG ; Zhu, C ; Patton, GC ; Viner, RM (ELSEVIER SCIENCE INC, 2021-10-30)
    BACKGROUND: Documentation of patterns and long-term trends in mortality in young people, which reflect huge changes in demographic and social determinants of adolescent health, enables identification of global investment priorities for this age group. We aimed to analyse data on the number of deaths, years of life lost, and mortality rates by sex and age group in people aged 10-24 years in 204 countries and territories from 1950 to 2019 by use of estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. METHODS: We report trends in estimated total numbers of deaths and mortality rate per 100 000 population in young people aged 10-24 years by age group (10-14 years, 15-19 years, and 20-24 years) and sex in 204 countries and territories between 1950 and 2019 for all causes, and between 1980 and 2019 by cause of death. We analyse variation in outcomes by region, age group, and sex, and compare annual rate of change in mortality in young people aged 10-24 years with that in children aged 0-9 years from 1990 to 2019. We then analyse the association between mortality in people aged 10-24 years and socioeconomic development using the GBD Socio-demographic Index (SDI), a composite measure based on average national educational attainment in people older than 15 years, total fertility rate in people younger than 25 years, and income per capita. We assess the association between SDI and all-cause mortality in 2019, and analyse the ratio of observed to expected mortality by SDI using the most recent available data release (2017). FINDINGS: In 2019 there were 1·49 million deaths (95% uncertainty interval 1·39-1·59) worldwide in people aged 10-24 years, of which 61% occurred in males. 32·7% of all adolescent deaths were due to transport injuries, unintentional injuries, or interpersonal violence and conflict; 32·1% were due to communicable, nutritional, or maternal causes; 27·0% were due to non-communicable diseases; and 8·2% were due to self-harm. Since 1950, deaths in this age group decreased by 30·0% in females and 15·3% in males, and sex-based differences in mortality rate have widened in most regions of the world. Geographical variation has also increased, particularly in people aged 10-14 years. Since 1980, communicable and maternal causes of death have decreased sharply as a proportion of total deaths in most GBD super-regions, but remain some of the most common causes in sub-Saharan Africa and south Asia, where more than half of all adolescent deaths occur. Annual percentage decrease in all-cause mortality rate since 1990 in adolescents aged 15-19 years was 1·3% in males and 1·6% in females, almost half that of males aged 1-4 years (2·4%), and around a third less than in females aged 1-4 years (2·5%). The proportion of global deaths in people aged 0-24 years that occurred in people aged 10-24 years more than doubled between 1950 and 2019, from 9·5% to 21·6%. INTERPRETATION: Variation in adolescent mortality between countries and by sex is widening, driven by poor progress in reducing deaths in males and older adolescents. Improving global adolescent mortality will require action to address the specific vulnerabilities of this age group, which are being overlooked. Furthermore, indirect effects of the COVID-19 pandemic are likely to jeopardise efforts to improve health outcomes including mortality in young people aged 10-24 years. There is an urgent need to respond to the changing global burden of adolescent mortality, address inequities where they occur, and improve the availability and quality of primary mortality data in this age group. FUNDING: Bill & Melinda Gates Foundation.
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    Global, regional, and national time trends in mortality for congenital heart disease, 1990-2019: An age-period-cohort analysis for the Global Burden of Disease 2019 study
    Su, Z ; Zou, Z ; Hay, SI ; Liu, Y ; Li, S ; Chen, H ; Naghavi, M ; Zimmerman, MS ; Martin, GR ; Wilner, LB ; Sable, CA ; Murray, CJL ; Kassebaum, NJ ; Patton, GC ; Zhang, H (ELSEVIER, 2022-01-01)
    BACKGROUND: Congenital heart disease (CHD) is the leading cause of morbidity and mortality from birth defects worldwide. We report an overview of trends in CHD mortality in 204 countries and territories over the past 30 years and associations with age, period, and birth cohort. METHODS: Cause-specific CHD mortality estimates were derived from the Global Burden of Disease 2019 study. We utilised an age-period-cohort model to estimate overall annual percentage changes in mortality (net drifts), annual percentage changes from 0 to 4 to 65-69 years (local drifts), period and cohort relative risks (period/cohort effects) between 1990 and 2019. This approach allows for the examination and differentiation of age, period, and cohort effects in the mortality trends, with the potential to identify disparities and treatment gaps in cardiac care. FINDINGS: CHD is the leading cause of deaths from non-communicable diseases (NCDs) in those under 20 years. Global CHD deaths in 2019 were 217,000 (95% uncertainty interval 177,000-262,000). There were 129 countries with at least 50 deaths. India, China, Pakistan, and Nigeria had the highest mortality, accounting for 39.7% of deaths globally. Between 1990 and 2019, the net drift of CHD mortality ranged from -2.41% per year (95% confidence interval [CI] -2.55, -2.67) in high Socio-demographic Index (SDI) countries to -0.62% per year (95% CI: -0.82, -0.42) in low-SDI countries. Globally, there was an emerging transition in the age distribution of deaths from paediatric to adult populations, except for an increasing trend of mortality in those aged 10-34 years in Mexico and Pakistan. During the past 30 years, favourable mortality reductions were generally found in most high-SDI countries like South Korea (net drift = -4.0% [95% CI -4.8 to -3.1] per year) and the United States (-2.3% [-2.5 to -2.0]), and also in many middle-SDI countries like Brazil (-2.7% [-3.1 to 2.4]) and South Africa (-2.5% [-3.2 to -1.8]). However, 52 of 129 countries had either increasing trends (net drifts ≥0.0%) or stagnated reductions (≥-0.5%) in mortality. The relative risk of mortality generally showed improving trends over time and in successively younger birth cohorts amongst high- and high-middle-SDI countries, with the exceptions of Saudi Arabia and Kazakhstan. 14 middle-SDI countries such as Ecuador and Mexico, and 16 low-middle-SDI countries including India and 20 low-SDI countries including Pakistan, had unfavourable or worsening risks for recent periods and birth cohorts. INTERPRETATION: CHD mortality is a useful and accessible indicator of trends in the provision of congenital cardiac care both in early childhood and across later life. Improvements in the treatment of CHD should reduce the risk for successively younger cohorts and shift the risk for all age groups over time. Although there were gains in CHD mortality globally over the past three decades, unfavourable period and cohort effects were found in many countries, raising questions about adequacy of their health care for CHD patients across all age groups. These failings carry significant implications for the likelihood of achieving the Sustainable Development Goal targets for under-5 years and NCD mortality. FUNDING: Supported by the National Natural Science Foundation of China (81525002, 31971048, 82073573 to ZZ and HZ), Shanghai Outstanding Medical Academic Leader program (2019LJ22 to HZ), and Collaborative Innovation Program of Shanghai Municipal Health Commission (2020CXJQ01 to HZ), the Bill & Melinda Gates Foundation for the Global Burden of Disease Project (to NJK) and NHMRC fellowship administered through the University of Melbourne (to GCP).
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    Creating the Strategic and Technical Advisory Group of Experts (STAGE) to advance maternal, newborn, child, adolescent health and nutrition: a new approach
    AlBuhairan, F ; Agarwal, K ; Arora, NK ; Arulkumaran, S ; Bhutta, Z ; Binka, F ; Castro, A ; Claeson, M ; Dao, B ; Darmstadt, G ; Duke, T ; English, M ; Jardali, F ; Merson, M ; Ferrand, RA ; Golden, A ; Golden, M ; Homer, C ; Jehan, F ; Kabiru, C ; Kirkwood, B ; Lawn, J ; Li, S ; Patton, G ; Ruel, M ; Sandall, J ; Sachdev, HS ; Tomlinson, M ; Waiswa, P ; Walker, D ; Zlotkin, S (BMJ PUBLISHING GROUP, 2021-01-01)
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    Young-adult compared to adolescent onset of regular cannabis use: A 20-year prospective cohort study of later consequences
    Chan, GCK ; Becker, D ; Butterworth, P ; Hines, L ; Coffey, C ; Hall, W ; Patton, G (WILEY, 2021-01-26)
    INTRODUCTION: This paper compares consequences of cannabis use initiated after high school with those of cannabis initiation in adolescence, with estimates of the proportion of adverse consequences accounted for by adult-onset and adolescent-onset cannabis users. METHODS: A state-representative sample in Victoria, Australia (n = 1792) participated in a 10-wave longitudinal study and was followed from age 15 to 35 years. Exposure variable: Patterns of cannabis use across 20 years. Outcomes at age 35: Alcohol use, smoking, illicit drug use, relationship status, financial hardship, depression, anxiety and employment status. RESULTS: Substantially more participants (13.6%) initiated regular use after high school (young-adult onset) than in adolescence (7.7%, adolescent onset). By the mid-30s, both young-adult and adolescent-onset regular users were more likely than minimal/non-users (63.5%) to have used other illicit drugs (odds ratio [OR] > 20.4), be a high-risk alcohol drinker (OR > 3.7), smoked daily (OR > 7.2) and less likely to be in relationships (OR < 0.4). As the prevalence of the young-adult-onset group was nearly double of the adolescent-onset group, it accounted for a higher proportion of adverse consequences than the adolescent-onset group. DISCUSSION AND CONCLUSIONS: Cannabis users who began regular use in their teens had poorer later life outcomes than non-using peers. The larger group who began regular cannabis use after leaving high school accounted for most cannabis-related harms in adulthood. Given the legalisation of cannabis use in an increasing number of jurisdictions, we should increasingly expect harms from cannabis use to lie in those commencing use in young adulthood.
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    A job for life: How the transition from education to employment predicts early mortality
    Patton, GC ; Raniti, M ; Reavley, N (ELSEVIER, 2021-02-25)
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    Mapping inequalities in exclusive breastfeeding in low- and middle-income countries, 2000-2018.
    Bhattacharjee, NV ; Schaeffer, LE ; Hay, SI ; Local Burden of Disease Exclusive Breastfeeding Collaborators, (Springer Science and Business Media LLC, 2021-08)
    Exclusive breastfeeding (EBF)-giving infants only breast-milk for the first 6 months of life-is a component of optimal breastfeeding practices effective in preventing child morbidity and mortality. EBF practices are known to vary by population and comparable subnational estimates of prevalence and progress across low- and middle-income countries (LMICs) are required for planning policy and interventions. Here we present a geospatial analysis of EBF prevalence estimates from 2000 to 2018 across 94 LMICs mapped to policy-relevant administrative units (for example, districts), quantify subnational inequalities and their changes over time, and estimate probabilities of meeting the World Health Organization's Global Nutrition Target (WHO GNT) of ≥70% EBF prevalence by 2030. While six LMICs are projected to meet the WHO GNT of ≥70% EBF prevalence at a national scale, only three are predicted to meet the target in all their district-level units by 2030.