scholarly journals Maternal assault admissions are associated with increased risk of child protection involvement

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Carol Orr ◽  
David B Preen ◽  
Rebecca Glauert ◽  
Melissa O'Donnell ◽  
Colleen Fisher ◽  
...  
Keyword(s):  
Child Maltreatment ◽  
Young Children ◽  
Administrative Data ◽  
Hospital Admissions ◽  
Cox Regression ◽  
Small Sample ◽  
Prenatal Period ◽  
Increased Risk ◽  
Linked Administrative Data ◽  
Aboriginal Children

IntroductionAlmost half of Australian women assaulted by their partner have children in their care. Evidence suggests a link between children’s exposure to violence, and subsequent maltreatment allegations. However, this evidence is limited by small sample sizes. Linked administrative data present an opportunity to further investigate this sensitive topic. Objectives and ApproachThis study investigated the relationship between assaults on mothers and subsequent child maltreatment allegations. The sample included all live births in Western Australia from 1990 to 2009 (N=524,534) and their parents, with follow up to 2013. Linked administrative data on child maltreatment allegations and mothers’ assault-related hospital admissions were obtained. Multivariate Cox regression estimated the risk of maltreatment allegation following maternal assault admission. Adjusted and unadjusted hazard ratios (HR) and 95\% confidence intervals (CI) were calculated for the risk of maltreatment allegation, and time (in months) between assault admission and the first maltreatment allegation. ResultsOne in five children whose mother had an assault admission had a subsequent maltreatment allegation, increasing to more than one in three children when restricted to assault admissions in the prenatal period. More than half of the children who had a maltreatment allegation after their mother was admitted for assault were Aboriginal. After adjusting for covariates, children whose mother had an assault admission had two-fold increased risk of having a maltreatment allegation. The risk of maltreatment allegation was greatest in young children, 5.5-year-old (SD=4.6), when restricted to maternal assault admissions in the prenatal period the children were younger at 4-year-old (SD=4.1). The time from maternal assault admission to maltreatment allegation was around 12 months longer for Aboriginal children than for non-Aboriginal children. Conclusion/ImplicationsChildren of mothers who have been assaulted are at higher risk of child maltreatment allegation. Targeted early intervention is required for families with young children, and pregnant women experiencing violence. The time to maltreatment allegation for Aboriginal children warrants community developed culturally-safe partnerships between Aboriginal communities and government services.

scholarly journals The Impact of Hearing Impairment on the Life Trajectories of Aboriginal Children in Remote Australia: Protocol for the Hearing Loss in Kids Project

10.2196/15464 ◽  
2020 ◽  
Vol 9 (1) ◽  
pp. e15464 ◽  
Author(s):  
Jiunn-Yih Su ◽  
Vincent Yaofeng He ◽  
Steven Guthridge ◽  
Sven Silburn
Keyword(s):  
Early Childhood ◽  
Academic Performance ◽  
Child Maltreatment ◽  
Hearing Impairment ◽  
School Attendance ◽  
Data Access ◽  
Individual Level ◽  
Increased Risk ◽  
Aboriginal Children ◽  
The Impact

Background Previous studies have reported a high prevalence of chronic otitis media (OM) and hearing impairment (HI) in Aboriginal children in the Northern Territory (NT) of Australia. Children affected by these disorders are believed to be at increased risk for adverse outcomes in early childhood development, school attendance, academic performance, and child maltreatment and youth offending. However, to date, there have been no studies quantifying the association between HI and these outcomes in this population. Objective This study will investigate the association between HI and the 5 outcomes in Aboriginal children living in remote NT communities. Methods Individual-level information linked across multiple administrative datasets will be used to conduct a series of retrospective observational studies on selected developmental and school outcomes. The predictor variables for all studies are the results from audiometric hearing assessments. The outcome measures are as follows: Australian Early Development Census results, representing developmental readiness for school, assessed around 5 years of age; Year 1 school attendance rates; Year 3 school-based academic performance, assessed in the National Assessment Program—Literacy and Numeracy; incidence of child maltreatment events (including both notifications and substantiated cases); and incidence of a first guilty verdict for youth offenders. Confounding and moderating factors available for the analysis include both community-level factors (including school fixed effects, socioeconomic status, level of remoteness, and housing crowdedness) and individual-level factors (including maternal and perinatal health and hospital admissions in early childhood). Results The study commenced in 2018, with ethics and data custodian approvals for data access and linkage. This has enabled the completion of data linkage and the commencement of data analysis for individual component studies, with findings expected to be published in 2019 and 2020. Conclusions This study will provide first evidence of the impact of OM-related HI on the developmental, educational, and social outcomes of Australian Aboriginal children. The findings are expected to have significant implications for policy development, service design, and resource allocation. International Registered Report Identifier (IRRID) RR1-10.2196/15464

scholarly journals Identifying young Aboriginal and Torres Strait Islander children in linked administrative data: A comparison of methods

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Bridgette J McNamara ◽  
Jocelyn Jones ◽  
Carrington CJ Shepherd ◽  
Lina Gubhaju ◽  
Grace Joshy ◽  
...  
Keyword(s):  
Administrative Data ◽  
Urban Areas ◽  
Torres Strait Islander ◽  
Perinatal Outcomes ◽  
Indigenous Status ◽  
Torres Strait ◽  
Linked Administrative Data ◽  
Median Approach ◽  
Family Based ◽  
Aboriginal Children

Background In the ongoing debate on optimum methods for identification of Indigenous people within linked administrative data, few studies have examined the impacts of method on population counts and outcomes in family-based linkage studies of Aboriginal children. Objective To quantify differences between three validated algorithms in ascertaining Aboriginal and Torres Strait Islander children in linked administrative data. Methods Linked administrative health data for children born in WA from 2000-2013, were used to examine the cohorts identified by three methods: A) the Indigenous Status Flag (ISF, derived by the WA Data Linkage Branch using a multistage-median approach) for the children alone; B) the ISF of the children, their parents and grandparents; and C) Indigenous status of the child, mother or father on either of the child’s perinatal records (Midwives or birth registration), to determine differing characteristics of each cohort. Results Method B established a larger cohort (33,697) than Method C (33,510) and Method A (27,482), with all methods identifying a core group of 26,993 children (80-98%). Compared with children identified by Method A, additional children identified by Methods B or C, were from less-disadvantaged and more urban areas, and had better perinatal outcomes (e.g. lower proportions of small-for-gestational age, 10% vs 16%). Differences in demographics and health outcomes between Methods C and B were minimal. Conclusions Demographic and perinatal health characteristics differ by Indigenous identification method. Using perinatal records or the ISF of parents and grandparents (in addition to the ISF of the child) appear to be more inclusive methods for identifying young Indigenous children in administrative datasets.

scholarly journals 282Social isolation and incident coronary heart disease in two large UK prospective studies

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Robert Smith ◽  
Isobel Barnes ◽  
Jane Green ◽  
Gillian Reeves ◽  
Valerie Beral ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Hospital Admission ◽  
Social Isolation ◽  
Hospital Admissions ◽  
Cox Regression ◽  
Coronary Event ◽  
Living Alone ◽  
Risk Of Death ◽  
Increased Risk

Abstract Background Social isolation is associated with CHD mortality but evidence of association with incident CHD is mixed. We prospectively examined this association in the Million Women Study (MWS) and UK Biobank (UKB). Methods 481,946 MWS and 456,612 UKB participants reported on social isolation (living alone, little contact with family/friends/groups). Excluding those reporting previous CHD or stroke, participants were followed for incident CHD using linkage to hospital admission and death records. Cox regression yielded relative risks (RR) by 3 levels of social isolation, adjusted for relevant confounders. Results During 7 years follow-up in the MWS and UKB, there were 42,402 first coronary heart disease events in total (of which 1,834 were fatal without an associated hospital admission). After adjustment, social isolation was not associated with hospital admission for first CHD events (combined RR for both studies: RR = 1.01, 95% CI: 0.98–1.04). However, the risk of fatal first CHD events without an associated hospital admission was substantially higher in the most isolated group than the least isolated group (1.86 [1.63–2.12]) This association with fatal first CHD events was driven by the association with living alone. Conclusions Social isolation was not associated with increased risk of first CHD hospital admissions but was associated with increased risk of death from CHD. Key messages Social isolation is likely not a risk factor for developing CHD, but people living alone may be at greater risk of dying from a coronary event than those not living alone.

Identification of Aboriginal children using linked administrative data: Consequences for measuring inequalities

2016 ◽  
Vol 52 (5) ◽  
pp. 534-540 ◽  
Author(s):  
Angela Gialamas ◽  
Rhiannon Pilkington ◽  
Jesia Berry ◽  
Daniel Scalzi ◽  
Odette Gibson ◽  
...  
Keyword(s):  
Administrative Data ◽  
Linked Administrative Data ◽  
Aboriginal Children

scholarly journals Socioeconomic trajectories and risk of hospitalization in the Moli-sani Study cohort

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Bonaccio ◽  
A Di Castelnuovo ◽  
S Costanzo ◽  
M Persichillo ◽  
A De Curtis ◽  
...  
Keyword(s):  
Life Course ◽  
Social Mobility ◽  
Hospital Admissions ◽  
Cox Regression ◽  
Educational Achievement ◽  
Study Cohort ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Direct Linkage ◽  
The Impact

Abstract Background A life course approach was used to explore the impact of socioeconomic status (SES) on risk of hospitalizations for all-cause and for cardiovascular disease (CVD). Methods Longitudinal analyses on 19,999 subjects apparently free from CVD and cancer, recruited in the Moli-sani Study, Italy (2005-2010). Low and high SES in childhood, educational attainment (low/high) and SES during adulthood (measured by a score including material resources and dichotomized as low/high) defined the trajectories over life course. First hospital admissions were recorded by direct linkage with hospital discharge form registry. Hazard ratios (HR) with 95% confidence interval (95%CI) were calculated by multivariable Cox-regression. Results Over a median follow up of 7.3 y, we ascertained a total of 7,594 all-cause and 2,539 CVD hospitalizations. Poor childhood SES was associated with 11% and 17% increased risk of all-cause and CVD hospitalizations, respectively. Among subjects with poor childhood SES, an upward trajectory in education was associated with lower risk of hospital admission for all-cause (HR = 0.85; 95%CI 0.76-0.94) and CVD (HR = 0.78; 0.64-0.95), as opposed to subjects remained stably low (low education and adulthood SES). Individuals with high childhood SES, but not educational achievement, were at 26% increased risk of hospitalization for any cause, as compared to the stably high SES group, while failure to achieve both educational and material advancements was associated with 37% higher risk of CVD hospitalization. Conclusions In a large sample of healthy adults, social mobility (educational and/or material upward trajectories) was associated with lower incidence of hospital admissions for all-cause and CVD. Key messages Social mobility may counterbalance the negative health burden associated with low early-life SES. High SES in childhood poorly affects hospitalization risk if no additional achievements across life course occur.

scholarly journals Malnutrition According to GLIM Criteria Is Associated with Mortality and Hospitalizations in Rehabilitation Patients with Stable Chronic Obstructive Pulmonary Disease

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 369
Author(s):  
Vanesa Dávalos-Yerovi ◽  
Ester Marco ◽  
Dolores Sánchez-Rodríguez ◽  
Xavier Duran ◽  
Delky Meza-Valderrama ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Cox Regression ◽  
Negative Impact ◽  
Fat Free Mass ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Age Related ◽  
Copd Patients ◽  
Increased Risk ◽  
Post Hoc

Malnutrition has a negative impact on patients with chronic pulmonary obstructive disease (COPD). The purpose of this study was to assess the prevalence of malnutrition, defined by the Global Leadership Initiative for Malnutrition (GLIM), in stable COPD patients referred to pulmonary rehabilitation, and to explore potential associations of malnutrition according to GLIM, and its components, with increased risk of mortality and hospitalizations in 2 years. In a post-hoc analysis of a prospective cohort of 200 rehabilitation patients with stable COPD, main outcome variables were hospital admissions, length of stay, and mortality during a 2-year follow-up. Covariates were malnutrition according to GLIM and its phenotypic criteria: unintentional weight loss, low body mass index (BMI), and low fat-free mass (FFM). Univariate and multivariate analysis were performed using logistic and proportional hazard Cox regression. Malnutrition according to GLIM showed 45% prevalence and was associated with increased mortality risk. Low age-related BMI and FFM were independently associated with mortality, which persisted after adjustment for age and lung function. Malnutrition and low BMI were also associated with increased risk of hospitalization. Malnutrition according to GLIM criteria was highly prevalent in rehabilitation patients with COPD and was associated with nearly 3 times greater mortality and hospitalization risk.

Abstract P649: Extracranial Hemorrhage in the Setting of Gastrointestinal Or Genitourinary Cancer is Associated With Increased Risk of Ischemic Stroke in Patients With Atrial Fibrillation

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Eric Zhou ◽  
Aaron Lord ◽  
Amelia K Boehme ◽  
Nils Henninger ◽  
Adam H De Havenon ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Hospital Admissions ◽  
Cox Regression ◽  
Anticoagulation Therapy ◽  
Bleeding Complications ◽  
Outcome Variable ◽  
Increased Risk ◽  
Exposure Variable

Background and Purpose: Anticoagulation therapy reduces the risk for ischemic stroke in atrial fibrillation (AF) but also predisposes patients to hemorrhagic complications. Patients with GI or GU cancer and AF are at higher risk of bleeding complications with anticoagulation therapy. There is limited knowledge on the risk of first-ever ischemic stroke in AF patients after extracranial hemorrhage (ECH) in patients with gastrointestinal or genitourinary (GI/GU) cancer. Methods: We conducted a retrospective study using the California State Inpatient Database (SID) including all non-federal hospital admissions in California from 2005-2011. The exposure variable was hospitalization with a diagnosis of ECH with a previous diagnosis of AF. The outcome variable was a subsequent hospitalization with acute ischemic stroke. We excluded patients with stroke prior to or at the time of ECH diagnosis. We calculated adjusted hazard ratios (HRs) for ischemic stroke during follow up and at 6-month intervals using Cox regression models adjusted for pertinent demographics and co-morbidities and stratifying patients with ECH based on the presence/absence of a GI/GU cancer. Results: We identified 764,257 AF patients (mean age 75 years, 49% women) without a documented history of stroke. Of these, 98,647 (13%) had an ECH-associated hospitalization, and 22,748 patients (3%) developed an ischemic stroke during a mean follow up. Compared to non-ECH patients, patients with ECH in the setting of a GI/GU cancer had a significantly higher risk of incident ischemic stroke (adjusted HR 1.40, 95% CI 1.20-1.64).Whereas there was only a modest increase in ischemic stroke risk in those without GI/GU cancer (adjusted HR 1.09 95% CI 1.05-1.13). Conclusion: AF patients hospitalized with ECH in the setting of GI/GU cancer have a particularly high risk of incident ischemic stroke. Particular consideration should be given to the optimal balance between the benefits and risks of anticoagulation therapy and the use of non-anticoagulant alternatives such as left atrial appendage closure in this vulnerable population.

Black–White Differences in Child Maltreatment Reports and Foster Care Placements: A Statistical Decomposition Using Linked Administrative Data

2017 ◽  
Vol 21 (3) ◽  
pp. 414-420 ◽  
Author(s):  
Tim Maloney ◽  
Nan Jiang ◽  
Emily Putnam-Hornstein ◽  
Erin Dalton ◽  
Rhema Vaithianathan
Keyword(s):  
Foster Care ◽  
Child Maltreatment ◽  
Administrative Data ◽  
Linked Administrative Data
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