The global incidence of acute pancreatitis (AP) is increasing, but little information exists about trends in Australia. This study aimed to describe incidence trends, along with clinical and ...socio-demographic associations, in the state of Tasmania over a recent 12-year period.
The study cohort was obtained by linking clinical and administrative datasets encompassing the whole Tasmanian population between 2007 and 2018, inclusive. Pancreatitis case definition was based on relevant ICD-10 hospitalization codes, or elevated serum lipase or amylase in pathology data.
Age-standardised incidence rates were estimated, overall and stratified by sex, aetiology, and Index of Relative Socio-economic Disadvantage (IRSD).
In the study period, 4905 public hospital AP episodes were identified in 3503 people. The age-standardised person-based incidence rate across the entire period was 54 per 100,000 per year. Incidence was inversely related to IRSD score; 71 per 100,000 per year in the most disadvantaged quartile compared to 32 in the least disadvantaged. Biliary AP incidence was higher than that of alcohol-related AP, although the greatest incidence was in “unspecified” cases. There was an increase in incidence for the whole cohort (average annual percent change 3.23 %), largely driven by the two most disadvantaged IRSD quartiles; the least disadvantaged quartile saw a slight overall decrease.
This is the first Australian study providing robust evidence that AP incidence is increasing and is at the upper limit of population-based studies worldwide. This increased incidence is greatest in socio-economically disadvantaged areas, meriting further research to develop targeted, holistic management strategies.
Objective
Socio‐economic‐status (SES) has rarely been reported or investigated in eating disorders (EDs) research. This Research Forum considers, from various perspectives, how SES may impact on ...evaluating evidence‐based treatments for EDs.
Method
We first reviewed previous literature that informs how SES impacts prevalence of EDs, help‐seeking, and treatment outcome. We then present findings from a case series effectiveness study of an early intervention program in low SES areas for EDs and discuss implications about the impact of SES on the effectiveness of evidence‐based interventions. Finally, we examine barriers to conducting rigorous evaluations in this population and discuss directions for future treatment outcome research.
Results
Evidence suggests a higher level of disordered eating but less help seeking in lower SES groups. In our case series, 96 participants started treatment and completed a mean of 13.85 sessions, 84 (87.5%) completed a mean of 6.40 sessional measures on ED cognitions and behaviors, but only 31% completed more extensive pre‐treatment and post‐treatment measures. The completer effect size decrease for the global Eating Disorder Examination‐Questionnaire score was 2.05 (95% CI: 1.43, 2.68) commensurate with other effectiveness studies in mixed SES groups. The high rates of missing data related to more extensive assessment present a barrier to evaluating evidence‐based treatments in this population.
Discussion
Evidence from the present study revealed individuals from low SES can achieve similar treatment outcomes to other populations when receiving evidence‐based ED treatment. Future studies should investigate a range of approaches to maximizing data collection, including use of shorter sessional measures.
Shared book reading is thought to have a positive impact on young children's language development, with shared reading interventions often run in an attempt to boost children's language skills. ...However, despite the volume of research in this area, a number of issues remain outstanding. The current meta-analysis explored whether shared reading interventions are equally effective (a) across a range of study designs; (b) across a range of different outcome variables; and (c) for children from different SES groups. It also explored the potentially moderating effects of intervention duration, child age, use of dialogic reading techniques, person delivering the intervention and mode of intervention delivery.
Our results show that, while there is an effect of shared reading on language development, this effect is smaller than reported in previous meta-analyses (g‾ = 0.194, p = .002). They also show that this effect is moderated by the type of control group used and is negligible in studies with active control groups (g‾ = 0.028, p = .703). Finally, they show no significant effects of differences in outcome variable (ps ≥ .286), socio-economic status (p = .658), or any of our other potential moderators (ps ≥ .077), and non-significant effects for studies with follow-ups (g‾ = 0.139, p = .200). On the basis of these results, we make a number of recommendations for researchers and educators about the design and implementation of future shared reading interventions.
•Shared book reading has been claimed to enhance children's language skills.•We have employed meta-analysis to test this claim.•The overall effects are small (especially at follow-up and with active controls).•We suggest some recommendations for future studies.
Aims
The aim of the study was to estimate the effect of household relative poverty on the risk of diabetic ketoacidosis at diagnosis of children with type 1 diabetes using an international standard ...measurement of relative poverty.
Methods
A national population‐based retrospective study was conducted. The Swedish National Diabetes Register (NDR) was linked with data from Sweden's public statistical agency (Statistics Sweden). Children who were diagnosed with new‐onset type 1 diabetes in the period of 2014–2019 were common identifiers. The definition of diabetic ketoacidosis was venous pH <7.30 or a serum bicarbonate level <18 mmol/L. The exposure variable was defined according to the standard definition of the persistent at‐risk‐of‐poverty rate used by the statistical office of the European Union (Eurostat) and several other European public statistical agencies. Univariate and multi‐variable analyses were used to calculate the effect of relative poverty on the risk of diabetic ketoacidosis.
Results
Children from households with relative poverty had a 41% higher risk of diabetic ketoacidosis (1.41, CI 1.12–1.77, p = 0.004) and more than double the risk of severe diabetic ketoacidosis (pH <7.10) (RR 2.10, CI 1.35–3.25, p = 0.001), as compared to children from households without relative poverty.
Conclusions
Relative poverty significantly increases the risk of diabetic ketoacidosis at onset of type 1 diabetes in children, even in a high‐income country with publicly reimbursed health care.
Latin America is one of the most ethnoracially heterogeneous regions of the world. Despite this, health disparities research in Latin America tends to focus on gender, class and regional health ...differences while downplaying ethnoracial differences. Few scholars have conducted studies of ethnoracial identification and health disparities in Latin America. Research that examines multiple measures of ethnoracial identification is rarer still. Official data on race/ethnicity in Latin America are based on self-identification which can differ from interviewer-ascribed or phenotypic classification based on skin color. We use data from Brazil, Colombia, Mexico, and Peru to examine associations of interviewer-ascribed skin color, interviewer-ascribed race/ethnicity, and self-reported race/ethnicity with self-rated health among Latin American adults (ages 18–65). We also examine associations of observer-ascribed skin color with three additional correlates of health – skin color discrimination, class discrimination, and socio-economic status. We find a significant gradient in self-rated health by skin color. Those with darker skin colors report poorer health. Darker skin color influences self-rated health primarily by increasing exposure to class discrimination and low socio-economic status.
•Uses newly collected data on 4921 adults from Brazil, Colombia, Mexico, and Peru.•Examines multiple measures of race/ethnicity and their associations with health.•Finds significant skin-color gradients in self-reported health.•Finds significant skin-color gradients in class-based discrimination and low SES.•SES and class-based discrimination largely account for disparities in health by skin color.
Background
In South Asia, 89 million children under 5 are at risk of not reaching their developmental potential. Household socioeconomic position (SEP) is a determinant of early child development ...(ECD). However, synthesised evidence for the association between ECD and SEP in young children in South Asia is not available. Therefore, this review synthesises evidence on the relationship of household SEP with ECD in children under 36 months of age in South Asia.
Method
PubMed, Cochrane Library, MEDLINE and Scopus were systematically searched to identify studies from South Asian countries that reported evidence on the association between SEP and ECD. Search terms included items related to motor, cognitive, language and socioemotional development. Study quality was assessed using the QualSyst tool, with three quality levels (high/medium/low), and a narrative review for each ECD outcome was constructed (PROSPERO registration: CRD42019131533).
Results
Twelve of the 950 publications screened met the inclusion criteria (nine from India, two Nepal and one Bangladesh). The majority (n = 10, 83%) reported language development on its own or alongside another ECD outcome. Fewer articles assessed cognitive (n = 6, 50%), motor (n = 7, 58%) or socioemotional development (n = 3, 25%). Higher SEP was associated with better ECD for one third of the associations reported. One ECD outcome (socioemotional development) was negatively associated (with socioeconomic status) based on low quality evidence. Mother's education and family income were the major SEP constructs associated with ECD. One, four and seven studies were rated as having a low, medium and high risk of bias, respectively.
Conclusion
This review reveals the scarcity of evidence exploring associations between household SEP and ECD in children under 36 months in South Asia, especially outside of India. Enhancing evidence for associations between ECD and SEP is needed for evidence‐based policy making to reduce developmental delays associated with a disadvantaged SEP in the South Asian region.
This paper investigates the relationship between music qualification choice and academic performance in secondary education in England at Key Stage 4 (KS4; usually at ages 15 and 16). We analysed ...data from 2257 pupils at 18 educational settings in a city in the southeast of England. Two regression analyses with clustered errors modelled KS4 music qualification choice and GCSE academic achievement in English, Mathematics and other English Baccalaureate subjects, while controlling for a range of demographic, academic and socio‐economic variables. Choice of music as a subject at KS4 was positively associated with the total volume of KS4 qualifications entered for examination and was also predicted by coming from an affluent neighbourhood. Furthermore, this choice of music at KS4 was associated with greater academic performance on English Baccalaureate subjects above and beyond other significant predictors (gender, language, prior academic achievement, total volume of KS4 qualifications and neighbourhood socio‐economic status; local Cohen's f‐squared = 0.09). These results point to moderate but significant additive effect of studying music at KS4 in relation to performance on core GCSE subjects. We also found that schools with KS4 music qualification choice greater than the national average were higher in overall academic attainment, in the proportion of pupils attending extra‐curricular instrumental lessons, and in our composite measure of school's engagement with a local music education hub. The results are interpreted in light of sociological theories of education in an attempt to better understand the underlying systemic factors affecting youth music engagement.
Objective
The purpose of this study was to analyse and map the distribution of the ageing population, by sociodemographic profiling, in private and public dental practices in Australia.
Background
...The rapid increase in the aged population in Australia requires a comprehensive approach to ensure accessibility to geriatric dental services. However, the availability of dental services for the older people requires further investigation of the demographic distribution of need.
Materials and Methods
Dental practices were located and mapped against the ageing population data. The address for each dental practice in Australia was compiled from online access sources. Australian socioeconomic data were integrated with dental practices, clinic locations and older populations using Geographic Information System (GIS) technology.
Results
There was an uneven distribution of dental practices across Australia's States and Territories (NT and ACT). Tasmania had the highest ratio of private practices to the older population (1:1000) and the highest percentages of this ageing cohort (32%, 61%) that lived more than 5 km from private and public dental practices respectively.
Higher percentages of dental practices were located in areas of lower socioeconomic status in Tasmania, Queensland and South Australia (47%, 42% and 38%) respectively, however, these areas were associated with higher ageing population densities.
Conclusion
There is a geographic maldistribution of dental practices in relation to the spatial distribution of Australia's older population, with the inequity most pronounced in the most disadvantaged areas. This inequality requires a National approach to match dental services to the population that they serve.
Background
Lockdown is one of the prevalent tools that are used to control the spread of COVID‐19 virus in India. Under the circumstances created during lockdown period, children are deprived from ...the social interaction and companionship; because of which, they are susceptible to psychiatric disorders. Therefore, in this study, efforts were to understand the impacts of lockdown on the mental status of the children of India and their specific causes.
Study Design
It is a questionnaire‐based study.
Methods
A web‐based questionnaire was prepared, and 400 parents from four districts of Punjab, India, namely, Ludhiana, Sahibzada Ajit Singh (SAS) Nagar, Sangrur and Ferozepur, were telephonically interviewed. Further, the information collected from the interviews was statistically analysed using Statistical Package for the Social Sciences (SPSS) software.
Results
Findings from this study revealed that 73.15% and 51.25% of the children were having signs of increased irritation and anger, respectively; 18.7% and 17.6% of the parents also mentioned the symptoms of depression and anxiety, respectively, among their children, which were also augmented by the changes in their diet, sleep, weight and more usage of the electronic equipment. Children (~76.3%) persistently urge to go outdoors and play with their friends; therefore, they could lag in social development. Further, observations from Pearson's correlation revealed that during lockdown, children's mental health is significantly related to the area of their house, number of children in the family, qualification of their mother and socio‐economic status of their family.
Conclusions
This study made it evident that the mental health of the children residing in Punjab, India, was compromised during the lockdown period induced by the COVID‐19 pandemic. Findings of this study may also trigger the international authorities to frame the guidelines of lockdown in the interest of mental health of their native children.
Objectives
This study aimed to assess the prevalence of awake bruxism and sleep bruxism in the Dutch adolescent population.
Materials and Methods
As part of a large epidemiologic survey on oral ...health of the general Dutch adolescent population in 2017, a total of 920 subjects were asked about their bruxism behaviour during daytime and during sleep. The collected data were subjected to stratified analysis by two age groups (for 17 and 23 years, respectively), gender and socio‐economic status.
Results
A prevalence of 4.1% and 4.2% was found for awake bruxism and of 7.6% and 13.2% for sleep bruxism. Women reported awake bruxism more often than men in the 17‐year‐old age group (5.0% and 3.2%, respectively), while in the 23‐year‐old age group it was the other way around (4.0% and 4.4%, respectively). Regarding sleep bruxism, women reported higher percentages than men in both age groups (7.8% versus 7.5% and 14.9% versus 11.5%, respectively). Concerning socio‐economic status (SES), awake bruxism was more often found in high SES groups (4.6% versus 3.7% and 4.9% versus 4.0% in both age groups, respectively) as well as for sleep bruxism in the 23‐year‐old group (16.5% versus 8.6%). In the 17‐year‐old group, sleep bruxism was more often reported in the low SES group (9.7% versus 5.3%).
Conclusions
Sleep bruxism is a common condition in the Dutch adolescent population, while awake bruxism is rarer.
Clinical relevance
Dental caregivers can use this information when negative healthcare outcomes are present amongst adolescents.
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