Publications
263 results found
Jayasooriya N, Pollok RC, Blackwell J, et al., 2023, Adherence to 5-aminosalicylic acid maintenance treatment in young people with ulcerative colitis: a retrospective cohort study in primary care, British Journal of General Practice, ISSN: 0960-1643
Background: Maintenance treatment with 5-aminosalicylic acid (5-ASA) is recommended in ulcerative colitis (UC), but accurate estimates of discontinuation and adherence in adolescents transitioning to young adulthood are lacking.Aim: To determine rates and risk factors for discontinuation and adherence to oral 5-ASA in adolescents and young adults 1 year following diagnosis of UC.Design and setting: Observational cohort study using the UK Clinical Practice Research Datalink among adolescents and young adults (aged 10–24 years) diagnosed with UC between 1 January 1998 and 1 May 2016.Method: Time to oral 5-ASA discontinuation (days) and adherence rates (proportion of days covered) were calculated during the first year of treatment using Kaplan–Meier survival analysis. Cox regression models were built to estimate the impact of sociodemographic and health-related risk factors.Results: Among 607 adolescents and young adults starting oral 5-ASA maintenance treatment, one-quarter (n = 152) discontinued within 1 month and two- thirds (n = 419) within 1 year. Discontinuation was higher among those aged 18–24 years (74%) than younger age groups (61% and 56% in those aged 10–14 and 15–17 years, respectively). Adherence was lower among young adults than adolescents (69% in those aged 18–24 years versus 80% in those aged 10–14 years). Residents in deprived versus affluent postcodes were more likely to discontinue treatment (adjusted hazard ratio [aHR] 1.46, 95% confidence interval [CI] = 1.10 to 1.92). Early corticosteroid use for an acute flare lowered the likelihood of oral 5-ASA discontinuation (aHR 0.68, 95% CI = 0.51 to 0.90).Conclusion: The first year of starting long-term therapies in adolescents and young adults diagnosed with UC is a critical window for active follow-up of maintenance treatment, particularly in those aged 18–24 years and those living in deprived postcodes.
Phillips SM, Summerbell C, Hesketh KR, et al., 2023, Co-design and content validity of the movement measurement in the early years (MoveMEY) tool for assessing movement behaviour of pre-school aged children, International Journal of Behavioral Nutrition and Physical Activity, Vol: 20, Pages: 1-16, ISSN: 1479-5868
BACKGROUND: Movement behaviours (physical activity, sedentary behaviour, and sleep) are important for pre-school children's health and development. Currently, no tools with appropriate content validity exist that concurrently capture these movement behaviours in young children. The aim of this study was to co-design and assess the content validity of a novel tool to concurrently measure movement behaviours in pre-school aged children (aged 3-4 years). METHODS: We followed four distinct steps to develop and assess the content validity of Movement Measurement in the Early Years (MoveMEY): (1) We conducted an extensive literature search, to identify pre-existing proxy measurement tools (questionnaires and diaries) to inform the design of a novel tool, which aimed to effectively capture movement behaviour guidelines of pre-school aged children. (2) We facilitated focus group discussions with parents and carers of pre-school aged children (n = 11) and (3) a qualitative survey with free text responses was completed by topic relevant researchers (n = 6), to co-design the measurement tool. (4) We assessed the content validity of the developed tool, MoveMEY, through interviews with parents of pre-school aged children (n = 12) following piloting of the tool. RESULTS: We developed an initial version of MoveMEY based on the format of an existing questionnaire and by mapping the content of questions to the guidelines. Co-design of MoveMEY resulted in changes to the format (e.g. short questionnaire to a seven-day diary) and content (e.g. inclusion of 'general information' questions on illness, disabilities and sleep disturbances; question on screen time before bed). Content validity assessment demonstrated that the items of MoveMEY were relevant and comprehensive for the assessment of children's movement behaviours. MoveMEY was felt to be comprehensible, however, parental suggestions were implemented to finalise and improve MoveMEY (e.g.
Pollok RC, Jayasooriya N, Baillie S, et al., 2023, Letter: delays to diagnosis of IBD-Challenges requiring a systematic approach. Authors' reply., Aliment Pharmacol Ther, Vol: 57
Creese H, Saxena S, Nicholls D, et al., 2023, The role of dieting, happiness with appearance, self-esteem, and bullying in the relationship between mental health and body-mass index among UK adolescents: a longitudinal analysis of the Millennium Cohort Study., EClinicalMedicine, Vol: 60, Pages: 1-13, ISSN: 2589-5370
BACKGROUND: Mental illness and obesity are among the biggest challenges to population health, they are linked, and may be modifiable during adolescence. We aimed to determine intervening pathways between mental health and BMI z-score symptoms across adolescence. METHODS: In this longitudinal cohort study, we used path models to examine self-reported dieting, happiness with appearance, self-esteem and bullying at 14 years as potential mediators of the cross-lagged relationship between mental health (via the Strengths and Difficulties Questionnaire) and Body Mass Index (BMI) z-score at 11 and 17 years by sex in the UK Millennium Cohort Study, a prospective cohort study of 18,818 children born in the UK between September 1st, 2000, and January 31st, 2002. Full, incomplete data on all singleton children still participating in the study by age 11 years were analysed in GSEM via maximum likelihood estimation (N = 12,450). FINDINGS: We found happiness with appearance and self-esteem, but not dieting or bullying, mediated the relationship between BMI age 11 and mental health age 17. Each increase in BMI z-score at 11 years was associated with 0.12 increase for boys and a 0.19 increase for girls in scores of unhappiness with appearance (boys: b 0.12, 95% C.I.; girls b 0.19, C.I. 0.14 to 0.23) and a 16% increase for boys and a 22% increase for girls in odds of low self-esteem (boys OR 1.16, 95% C.I. 1.07 to 1.26; girls: OR 1.22, 95% C.I. 1.15 to 1.30) at 14 years. In turn, for both boys and girls, being unhappy with appearance and low self-esteem at 14 years were associated with a greater likelihood of emotional and externalizing symptoms at 17 years. INTERPRETATION: Early prevention strategies to encourage healthy physical and mental development of children need to focus on the promotion of positive body-mage and self-esteem. FUNDING: The National Institute for Health and Care Research (NIHR) School for Public Health Research (SPHR).
Pollok RC, Baillie S, Jayasooriya N, et al., 2023, Letter: diagnostic delay in inflammatory bowel disease-Authors' reply., Aliment Pharmacol Ther, Vol: 57, Pages: 1205-1206
Jayasooriya N, Saxena S, Pollok RC, 2023, Letter: fulminant onset complicated inflammatory bowel disease (IBD) - a unique subtype? Authors' reply., Aliment Pharmacol Ther, Vol: 57, Pages: 1194-1195
Mytton OT, Nicholls D, Saxena S, et al., 2023, Approach to a child or young person with concerns about excess weight., BMJ, Vol: 380
Jayasooriya N, Baillie S, Blackwell J, et al., 2023, Systematic review with meta-analysis: Time to diagnosis and the impact of delayed diagnosis on clinical outcomes in inflammatory bowel disease, ALIMENTARY PHARMACOLOGY & THERAPEUTICS, ISSN: 0269-2813
Ram B, van Sluijs E, Chalkley A, et al., 2023, Real-world application of a scalable school-based physical activity intervention: A cross-sectional survey of the implementation of The Daily Mile in Greater London primary schools., PLoS One, Vol: 18
School-based physical activity interventions are considered ideal given their potential to reach most children. They can help children achieve the recommended guidelines of 60 minutes of moderate-to-vigorous physical activity per day. The Daily Mile is a popular school-based active mile intervention with a global reach. It recommends ten core principles for successful implementation, three of which are key for effectiveness: that it is quick (15 minutes), the whole school participates, and that it takes place in the school day during lessons (excluding physical education lessons and scheduled breaks). Studies assessing the impacts of The Daily Mile do not often report implementation of the ten core principles which is crucial to identifying the potential impact and feasibility of scalable interventions in real-world settings. Our aim was to assess adherence to The Daily Mile's ten core principles in Greater London primary schools. We created and distributed a survey to 1717 primary schools during September 2020 and achieved a 21% (n = 369/1717) response rate by September 2021. Our sample was representative of Greater London primary schools with responses from every London borough. A total of 196/369 (53%) schools reported implementing The Daily Mile but none of them reported adherence to all ten core principles. Adherence to at least 6/10 principles in various combinations was reported by 54/196 (28%) schools. Only 19/196 (10%) schools that reported implementing The Daily Mile reported adherence to the three key principles recommended for effectiveness. Despite its popularity and global reach, our findings suggest that an implementation gap exists when The Daily Mile is adopted in real-world settings which is likely to challenge its intended purpose. Further research in school settings is needed to understand factors that can improve adherence to increase the potential public health impact of The Daily Mile and other similar interventions.
Foley KA, Maile EJ, Bottle A, et al., 2022, How did the covid-19 pandemic affect lower respiratory tract infections in young children in England?, EUROPEAN JOURNAL OF PUBLIC HEALTH, Vol: 32, ISSN: 1101-1262
Ram B, Foley K, van Sluijs E, et al., 2022, Developing a core outcome set for physical activity interventions in primary schools: a modified-Delphi study, BMJ Open, Vol: 12, Pages: 1-11, ISSN: 2044-6055
Objectives To develop a core outcome set for physical activity interventions in primary schools.Design Modified-Delphi. Setting UK and international. Participants 104 participants from four stakeholder groups (educators, public health professionals, health researchers, parents); 16 children (aged 8-9 years) from one London primary school. Interventions Physical activity interventions.Methods Four-stage process: (1) outcomes extracted from relevant studies identified from an umbrella review, and a focus group; (2) list of outcomes produced and domains established; (3) stakeholders completed a 2-round Delphi survey by rating (Round 1) and re-rating (Round 2) each outcome on a 9-point Likert scale from ‘not important’ to ‘critical’; a >70% participant threshold identified the outcomes rated ‘critical’ to measure, and outcomes important to children were identified through a workshop; (4) a stakeholder meeting to achieve consensus of the outcomes to include in the core outcome set. Results Seventy-four studies were extracted from 53 reviews. A list of 50 outcomes was produced and three domains established: ‘physical activity and health’ (16 outcomes), ‘social and emotional health’ (22 outcomes), and ‘educational performance’ (12 outcomes). 104 participants completed survey Round 1; 65 participants completed both rounds. Thirteen outcomes met the threshold; children identified 8 outcomes. Fourteen outcomes achieved consensus to produce the core outcome set; five outcomes for physical activity and health (diet [varied and balanced], energy, fitness, intensity of physical activity, sleep [number of hours]); seven for social and emotional health (anxiety, depression, enjoyment, happiness, self-esteem, stress, wellbeing); and two outcomes for educational performance (concentration, focus).Conclusions We have developed the first core outcome set for physical activity interventions in primary schools in
Venkatraman T, Honeyford C, Ram B, et al., 2022, Identifying local authority need for, and uptake of, school-based physical activity promotion in England – a cluster analysis, Journal of Public Health, Vol: 44, Pages: 694-703, ISSN: 1741-3842
Background:School-based physical activity interventions such as The Daily Mile (TDM) are widely promoted in children’s physical activity guidance. However, targeting such interventions to areas of greatest need is challenging since determinants vary across geographical areas. Our study aimed to identify local authorities in England with the greatest need to increase children’s physical activity and assess whether TDM reaches school populations in areas with the highest need.Methods:This was a cross-sectional study using routinely collected data from Public Health England. Datasets on health, census and the built environment were linked. We conducted a hierarchical cluster analysis to group local authorities by ‘need’ and estimated the association between ‘need’ and registration to TDM.Results:We identified three clusters of high, medium and low need for physical activity interventions in 123 local authorities. Schools in high-need areas were more likely to be registered with TDM (incidence rate ratio 1.25, 95% confidence interval: 1.12–1.39) compared with low-need areas.Conclusions:Determinants of children’s physical activity cluster geographically across local authorities in England. TDM appears to be an equitable intervention reaching schools in local authorities with the highest needs. Health policy should account for clustering of health determinants to match interventions with populations most in need.
van den Akker M, Dieckelmann M, Hussain MA, et al., 2022, Children and adolescents are not small adults: toward a better understanding of multimorbidity in younger populations., J Clin Epidemiol, Vol: 149, Pages: 165-171
Multimorbidity is of an increasing importance for the health of both children and adults but research has hitherto focused on adult multimorbidity. Hence, public awareness, practice, and policy lack vital information about multimorbidity in childhood and adolescence. We convened an international and interdisciplinary group of experts from six nations to identify key priorities supported by published evidence to strengthen research for children and adolescent with multimorbidity. Future research is encouraged (1) to develop a conceptual framework to capture unique aspects of child and adolescent multimorbidity-including definitions, characteristic patterns of conditions for different age groups, its dynamic nature through childhood and adolescence, and understanding of severity and trajectories for different clusters of multiple chronic conditions, (2) to define new indices to classify the presence of multimorbidity in children and adolescents, (3) to improve the availability and linkage of data across countries, (4) to synthesize evidence on the global phenomenon of multimorbidity in childhood and adolescence and health inequalities, and (5) to involve children and adolescents in research relevant to their health.
Ma R, Foley K, Saxena S, 2022, Access to and use of contraceptive care during the first COVID-19 lockdown in the UK: a web-based survey., BJGP Open, Vol: 6
BACKGROUND: The first wave of lockdown measures to control the COVID-19 pandemic in the UK resulted in suspension of 'non-essential' services, including contraceptive care. AIM: To examine women's perceptions and experiences of contraceptive care in the UK during the first lockdown. DESIGN & SETTING: A cross-sectional survey during the lockdown period from March-June 2020. METHOD: An online questionnaire was designed asking women aged 16-54 years their experiences of contraceptive care during lockdown. Questions were based on Maxwell's evaluation framework on access, acceptability, relevance or appropriateness, and equity. It was promoted on social media from 27 May-9 June 2020. A descriptive analysis was conducted of quantitative data and thematic analysis of free-text data. RESULTS: In total, 214 responses were analysed. General practice was the source of contraception for 43.4% (n = 49) and 52.3% (n = 34) of responders before and during the lockdown, respectively. The study found 55.1% (n = 118) of responders, including regular and new users, were uncertain where or how to get contraception during the pandemic. Responders reported reduced access to contraception during lockdown, and some thought sexual health clinics and general practices were closed. Remote consultations and electronic prescriptions facilitated contraceptive access for some responders. Long-acting reversible contraception (LARC) was unavailable in some areas owing to restrictions, and alternatives were not acceptable to those who used methods for non-contraceptive benefits to treat medical conditions; for example, menorrhagia. CONCLUSION: The study highlighted the need for better information and signposting for contraception during lockdown. Contraception, including LARC, should be reframed as an essential service with robust signposting for pandemic planning and beyond.
Bottle A, Neale FK, Foley KA, et al., 2022, Impact of COVID-19 on outpatient appointments in children and young people in England: an observational study, BMJ OPEN, Vol: 12, ISSN: 2044-6055
Saxena S, Skirrow H, Wighton K, 2022, Vaccinating children aged under 5 years against covid-19, BMJ: British Medical Journal, Pages: o1863-o1863, ISSN: 0959-535X
Foley KA, Saxena SK, Majeed A, et al., 2022, Author response., Br J Gen Pract, Vol: 72, Pages: 318-318
Foley K, Maile E, Bottle R, et al., 2022, Impact of covid-19 on primary care contacts with children and young people aged 0-24 years in England; longitudinal trends study 2015-2020, British Journal of General Practice, ISSN: 0960-1643
Background: The NHS response to covid-19 altered provision and access to primary care.Aim: To examine the impact of covid-19 on general practitioner (GP) contacts with children and young people in England. Design and Setting: Longitudinal trends analysis using electronic health records from the Clinical Practice Research Datalink Aurum database.Methods: We included all children and young people younger than 25 years registered with a GP. We compared the number of total, remote and face-to-face contacts during the first UK lockdown (March to June 2020) with the mean contacts for comparable weeks from 2015 to 2019.Results: We examined 47 607 765 GP contacts with 4 307 120 million children and young people. GP contacts fell 41% during the first lockdown compared with previous years. Children aged 1-14 had greater falls in total contacts (>50%) compared with infants and 15-24s. Face-to-face contacts fell by 88% with the greatest falls occurring among children aged 1-14 (> 90%). Remote contacts more than doubled, increasing most in infants (over 2.5 fold). Total contacts for respiratory illnesses fell by 74% whereas contacts for common non-transmissible conditions shifted largely to remote, mitigating the total fall (31%). Conclusion: During the covid-19 pandemic, children and young people’s contact with GPs fell, particularly for face-to-face assessment. This may be explained by a lower incidence of respiratory illnesses due to fewer social contacts and changing health seeking behaviour. The large shift to remote contacts mitigated total falls in contacts for some age groups and for common non-transmissible conditions.
Saxena S, Skirrow H, Maini A, et al., 2022, Consenting children aged under 18 for vaccination and treatment, BMJ: British Medical Journal, Vol: 377, ISSN: 0959-535X
Vaccine programmes for young people during thecovid-19 pandemic have highlighted common legaland ethical dilemmas that can arise when consentingchildren aged under 18 for medical treatment orintervention.1 -3 These can be especially challengingwhen a parent or guardian’s views differ from thoseof the child.This article summarises the issues around consentingchildren under 18 for treatment using vaccination asan exemplar. Most of the article is based on guidanceand law in the UK; however, the principles behindthe laws described may be applicable in othersettings. We recommend that health professionalsoutside the UK also check their local laws regardingconsent for children’s treatments and vaccinations.
Smith HC, Saxena S, Petersen I, 2022, Maternal Postnatal Depression and Completion of Infant Immunizations: A UK Cohort Study of 196,329 Mother-Infant Pairs, 2006-2015., J Clin Psychiatry, Vol: 83
Objective: To examine the relationship between maternal postnatal depression and completion of infant vaccinations. Methods: We conducted a cohort study using data from The Health Improvement Network (THIN), a large UK primary care electronic health record database. We identified 196,329 mother-infant pairs in which the infant was born between 2006 and 2015. Postnatal depression was identified through antidepressant prescriptions or diagnoses or symptoms of depression in first year after childbirth. Primary outcome was completion of three 5-in-1 vaccination doses in infants before 1 year of age; this vaccine protects against diphtheria, tetanus, whooping cough, polio, and Haemophilus influenzae type b. We used Poisson regression models to compare likelihood of infant 5-in-1 vaccine uptake among children of women with a record of postnatal depression to likelihood among those without. Results: Of the 196,329 women, 20,802 (10.6%) had a record of postnatal depression and/or antidepressant prescription. There was no difference in infants' 5-in-1 vaccination completion between those of mothers with a record and those of mothers' without (adjusted incidence rate ratio [IRR] = 1.01; 95% CI, 0.99-1.02). Those from more socially deprived areas were less likely to complete infant vaccinations compared to those from the least deprived areas (IRR = 0.92; 95% CI, 0.90-0.93). Likelihood of completing infant vaccination decreased over time, comparing 2014-2015 to 2006-2007 (IRR = 0.90; 95% CI, 0.89-0.92). Conclusions: Among mothers who engage with primary care, maternal postnatal depression is not associated with lower rates of infant vaccination, though more research is needed to conclude if either more severe depression or unrecognized depression is associated with lower completion rates.
Blackwell J, Saxena S, Jayasooriya N, et al., 2022, Stoma Formation in Crohn's Disease and the Likelihood of Antidepressant Use: A Population-Based Cohort Study, CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, Vol: 20, Pages: E703-E710, ISSN: 1542-3565
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Phillips SM, Summerbell C, Hobbs M, et al., 2021, A systematic review of the validity, reliability, and feasibility of measurement tools used to assess the physical activity and sedentary behaviour of pre-school aged children, International Journal of Behavioral Nutrition and Physical Activity, Vol: 18, Pages: 1-28, ISSN: 1479-5868
Physical activity (PA) and sedentary behaviour (SB) of pre-school aged children are associated with important health and developmental outcomes. Accurate measurement of these behaviours in young children is critical for research and practice in this area. The aim of this review was to examine the validity, reliability, and feasibility of measurement tools used to assess PA and SB of pre-school aged children.Searches of electronic databases, and manual searching, were conducted to identify articles that examined the measurement properties (validity, reliability or feasibility) of measurement tools used to examine PA and/or SB of pre-school aged children (3-7 years old). Following screening, data were extracted and risk of bias assessment completed on all included articles. A total of 69 articles, describing 75 individual studies were included. Studies assessed measurement tools for PA (n=27), SB (n=5), and both PA and SB (n=43). Outcome measures of PA and SB differed between studies (e.g. moderate to vigorous activity, step count, posture allocation). Most studies examined the measurement properties of one measurement tool only (n=65). Measurement tools examined included: calorimetry, direct observation, combined heart rate and accelerometry, heart rate monitors, accelerometers, pedometers, and proxy report (parent, carer or teacher reported) measures (questionnaires or diaries). Studies most frequently assessed the validity (criterion and convergent) (n=65), face and content validity (n=2), test-retest reliability (n=10) and intra-instrument reliability (n=1) of the measurement tools. Feasibility data was abstracted from 41 studies.Multiple measurement tools used to measure PA and SB in pre-school aged children showed some degree of validity, reliability and feasibility, but often for different purposes. Accelerometers, including the Actigraph (in particular GT3X versions), Actical, ActivPAL and Fitbit (Flex and Zip), and proxy reported measurement tools used in co
Ward JL, Azzopardi PS, Francis KL, et al., 2021, 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, The Lancet, Vol: 398, Pages: 1593-1618, ISSN: 0140-6736
BackgroundDocumentation 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.MethodsWe 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).FindingsIn 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 mater
Greenfield G, Okoli O, Quezada Yamamoto H, et al., 2021, Characteristics of frequently attending children in hospital emergency departments: a systematic review, BMJ Open, Vol: 11, Pages: 1-7, ISSN: 2044-6055
Objective: To summarise the literature on frequent attendances to hospital emergency departments and describe sociodemographic and clinical characteristics of children who attend EDs frequently.Setting: Hospital emergency departments.Participants: Children <21 years, attending hospital emergency departments frequently.Primary outcome measures: Outcomes measures were defined separately in each study, and were predominantly the number of ED attendances per year.Results: We included 21 studies representing 6,513,627 children. Between 0.3% to 75% of all paediatric ED users were frequent users. Most studies defined 4 or more visits per year as a “frequent ED” usage. Children who were frequent ED users were more likely to be less than 5 years old. In the US, patients with public insurance were more likely to be frequent attenders. Frequent ED users more likely to be frequent users of primary care and have long-term conditions; the most common diagnoses were infections and gastroenteritis.Conclusions: The review included a wide range of information across various health systems, however children who were frequent ED users have some universal characteristics in common. Policies to reduce frequent attendance might usefully focus on preschool children and supporting primary care in responding to primary-care oriented conditions.
Creese H, Lai E, Mason K, et al., 2021, Disadvantage in early-life and persistent asthma in adolescents: a UK cohort study, THORAX, Vol: 77, Pages: 854-864, ISSN: 0040-6376
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Ram B, Foley K, van Sluijs E, et al., 2021, A core outcome set for school-based physical activity interventions: an international consensus, Publisher: OXFORD UNIV PRESS, ISSN: 1101-1262
Ram B, Chalkley A, van Sluijs E, et al., 2021, Implementation of The Daily Mile (TM) : survey of primary schools in Greater London, 14th European Public Health Conference Public health futures in a changing world, Publisher: Oxford University Press, ISSN: 1101-1262
Saxena S, Skirrow H, Bedford H, et al., 2021, Covid-19 vaccines for teenagers: conversations and consent, BMJ, Vol: 374, Pages: 1-2, ISSN: 1759-2151
Paulson KR, Kamath AM, Alam T, et al., 2021, Global, regional, and national progress towards Sustainable Development Goal 3.2 for neonatal and child health: all-cause and cause-specific mortality findings from the Global Burden of Disease Study 2019, The Lancet, Vol: 398, Pages: 870-905, ISSN: 0140-6736
BackgroundSustainable Development Goal 3.2 has targeted elimination of preventable child mortality, reduction of neonatal death to less than 12 per 1000 livebirths, and reduction of death of children younger than 5 years to less than 25 per 1000 livebirths, for each country by 2030. To understand current rates, recent trends, and potential trajectories of child mortality for the next decade, we present the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 findings for all-cause mortality and cause-specific mortality in children younger than 5 years of age, with multiple scenarios for child mortality in 2030 that include the consideration of potential effects of COVID-19, and a novel framework for quantifying optimal child survival.MethodsWe completed all-cause mortality and cause-specific mortality analyses from 204 countries and territories for detailed age groups separately, with aggregated mortality probabilities per 1000 livebirths computed for neonatal mortality rate (NMR) and under-5 mortality rate (U5MR). Scenarios for 2030 represent different potential trajectories, notably including potential effects of the COVID-19 pandemic and the potential impact of improvements preferentially targeting neonatal survival. Optimal child survival metrics were developed by age, sex, and cause of death across all GBD location-years. The first metric is a global optimum and is based on the lowest observed mortality, and the second is a survival potential frontier that is based on stochastic frontier analysis of observed mortality and Healthcare Access and Quality Index.FindingsGlobal U5MR decreased from 71·2 deaths per 1000 livebirths (95% uncertainty interval [UI] 68·3–74·0) in 2000 to 37·1 (33·2–41·7) in 2019 while global NMR correspondingly declined more slowly from 28·0 deaths per 1000 live births (26·8–29·5) in 2000 to 17·9 (16·3–19·8) in 2019.
Venkatraman T, Honeyford K, Ram B, et al., 2021, IDENTIFYING LOCAL AUTHORITY NEED FOR, AND UPTAKE OF, SCHOOL-BASED PHYSICAL ACTIVITY INTERVENTIONS IN ENGLAND - A CLUSTER ANALYSIS USING ROUTINE DATA, Publisher: BMJ PUBLISHING GROUP, Pages: A24-A25, ISSN: 0143-005X
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