scholarly journals Using Linked Data to Examine the Epidemiology of All-Cause and Cause-Specific Mortality Following Release from Incarceration in Eleven Countries

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Rohan Borschmann ◽  
Claire Keen ◽  
Jesse T Young ◽  
Alexander D Love ◽  
Matthew Spittal ◽  
...  
Keyword(s):  
Linked Data ◽  
Mental Health Problems ◽  
Meta Analysis ◽  
Physical And Mental Health ◽  
Relevant Evidence ◽  
Analysis Methodology ◽  
Increased Risk ◽  
Global Epidemiology ◽  
Individual Participant ◽  
Causes And Risk Factors

IntroductionMore than 30 million adults are released from incarceration globally each year. Many experience complex physical and mental health problems, and are at markedly increased risk of preventable mortality. Despite this, evidence regarding the global epidemiology of mortality following release from incarceration is insufficient to inform the development of targeted, evidence-based responses. Many previous studies have suffered from inadequate power and poor precision, and even large studies have limited capacity to disaggregate data by specific causes of death, sub-populations or time since release to answer questions of clinical and public health relevance. Objectives and ApproachWe aimed to comprehensively document the incidence, timing, causes and risk factors for mortality in adults released from incarceration. We created the Mortality After Release from Incarceration Consortium (MARIC), a multi-disciplinary collaboration representing 29 cohorts of adults who have experienced incarceration from 11 countries. Findings across cohorts will be analysed using a two-step, individual participant data meta-analysis methodology. ResultsUsing linked data from the 29 individual cohorts, the combined sample includes 1,337,993 individuals (89% male), with 75,795 deaths recorded over 9,191,393 person-years of follow-up. Preliminary analyses indicate a marked elevation in mortality risk following release from incarceration, with this risk beginning on the day of release. At the time of writing, more detailed analyses are underway regarding all-cause and cause-specific deaths – along with risk and protective factors – and findings will be presented at the IPDLN conference in October. Conclusion / ImplicationsThe MARIC consortium represents an important advancement in the field, bringing international attention to this problem. It will provide internationally relevant evidence to guide policymakers and clinicians in reducing preventable deaths in this marginalised population.

scholarly journals The Mortality After Release from Incarceration Consortium (MARIC): Protocol for a multi-national, individual participant data meta-analysis

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Rohan Borschmann ◽  
Holly Tibble ◽  
Matthew J Spittal ◽  
David Preen ◽  
Jane Pirkis ◽  
...  
Keyword(s):  
Mental Health Problems ◽  
Meta Analysis ◽  
Individual Participant Data ◽  
Physical And Mental Health ◽  
Relevant Evidence ◽  
Analysis Methodology ◽  
Increased Risk ◽  
Global Epidemiology ◽  
Individual Participant ◽  
Causes And Risk Factors

IntroductionMore than 30 million adults are released from incarceration globally each year. Many experience complex physical and mental health problems, and are at markedly increased risk of preventable mortality. Despite this, evidence regarding the global epidemiology of mortality following release from incarceration is insufficient to inform the development of targeted, evidence-based responses. Many previous studies have suffered from inadequate power and poor precision, and even large studies have limited capacity to disaggregate data by specific causes of death, sub-populations or time since release to answer questions of clinical and public health relevance.   ObjectivesTo comprehensively document the incidence, timing, causes and risk factors for mortality in adults released from prison. MethodsWe created the Mortality After Release from Incarceration Consortium (MARIC), a multi-disciplinary collaboration representing 29 cohorts of adults who have experienced incarceration from 11 countries. Findings across cohorts will be analysed using a two-step, individual participant data meta-analysis methodology. ResultsThe combined sample includes 1,337,993 individuals (89% male), with 75,795 deaths recorded over 9,191,393 person-years of follow-up. ConclusionsThe consortium represents an important advancement in the field, bringing international attention to this problem. It will provide internationally relevant evidence to guide policymakers and clinicians in reducing preventable deaths in this marginalized population. Key wordsMortality; incarceration; prison; release; individual participant data meta-analysis; consortium; cohort.    

scholarly journals 535The epidemiology of all-cause and cause-specific mortality following release from prison in 11 countries

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Rohan Borschmann ◽  
Holly Tibble ◽  
Matthew Spittal ◽  
David Preen ◽  
Jane Pirkis ◽  
...  
Keyword(s):  
Mental Health Problems ◽  
Meta Analysis ◽  
Physical And Mental Health ◽  
Relevant Evidence ◽  
Analysis Methodology ◽  
Increased Risk ◽  
Global Epidemiology ◽  
Individual Participant ◽  
Causes And Risk Factors

Abstract Background More than 30 million adults are released from incarceration globally each year. Many experience complex physical and mental health problems, and are at markedly increased risk of preventable mortality. Despite this, evidence regarding the global epidemiology of mortality following release from incarceration is insufficient to inform the development of targeted, evidence-based responses. Many previous studies have suffered from inadequate power and poor precision, and even large studies have limited capacity to disaggregate data by specific causes of death, sub-populations or time since release to answer questions of clinical and public health relevance. Methods We aimed to comprehensively document the incidence, timing, causes and risk factors for mortality in adults released from incarceration. We created the Mortality After Release from Incarceration Consortium (MARIC), a multi-disciplinary collaboration representing 29 cohorts of adults who have experienced incarceration from 11 countries. Findings across cohorts will be analysed using a two-step, individual participant data meta-analysis methodology. Results Using linked data from the 29 individual cohorts, the combined sample includes 1,337,993 individuals (89% male), with 75,795 deaths recorded over 9,191,393 person-years of follow-up. Preliminary analyses indicate a marked elevation in mortality risk following release from incarceration, with this risk beginning on the day of release. At the time of writing, more detailed analyses are underway regarding all-cause and cause-specific deaths – along with risk and protective factors – and findings will be presented at the WCE conference. Conclusions The MARIC consortium represents an important advancement in the field, bringing international attention to this problem. Key messages The MARIC consortium will provide internationally relevant evidence to guide policymakers and clinicians in reducing preventable deaths in this marginalised population.

scholarly journals The Mortality After Release from Incarceration Consortium (MARIC) study: Strengths of international data linkage

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Rohan Borschmann ◽  
Stuart Kinner ◽  
Matthew Spittal
Keyword(s):  
Mental Health Problems ◽  
Meta Analysis ◽  
Physical And Mental Health ◽  
Policy Makers ◽  
Risk Of Death ◽  
Crude Mortality Rate ◽  
Increased Risk ◽  
Individual Participant ◽  
History Of ◽  
International Data

IntroductionAdults released from incarceration experience complex physical and mental health problems, and are at markedly increased risk of preventable death. Despite this, not enough is known about the granular epidemiology of mortality in this population to inform development of targeted, evidence-based responses. Objectives and ApproachWe created the Mortality After Release from Incarceration Consortium (MARIC), a multi-disciplinary collaboration from 12 countries representing 30 cohorts of adults with a history of incarceration. The combined sample size is 1,210,168, with 58,840 deaths recorded over 8,261,743 person-years of follow-up time. In this protocol paper, using a two-step, individual participant data meta-analysis (IPDM-A) methodology involving 22 MARIC cohorts, we calculated 1) a crude mortality rate (CMR; with 95% confidence intervals) for each individual cohort over the first 84 days (12 weeks) following release; and 2) a combined, meta-analysed CMR for the same period. ResultsOf 1,704,208 individual releases, we observed 4,018 deaths over the first 84 days. The overall CMR over the first 84 days after release was 1610.97 deaths per 100,000 person-years (95% CI: 1263.4 - 1958.5). The rate was highest on the day of release (5768.0; 95% CI: 3296.5 - 8239.4), which was significantly higher than on days 4-84. Conclusion/ImplicationsAdults released from incarceration were at an acutely increased risk of death on the day of release, and this risk remained elevated for at least the first 12 weeks. The MARIC study will provide decisive and empirical evidence to guide clinicians and policy makers in reducing mortality in this marginalized

scholarly journals Child Maltreatment: Brief Communication

2019 ◽  
Vol 4 (7) ◽  
pp. 105-110
Author(s):  
Amanda Plácido da Silva Macêdo ◽  
Monnic Maria Lóssio Rocha Maia ◽  
Izadora De Sousa Pereira ◽  
Thânia Maria Rodrigues Figueiredo ◽  
Modesto Leite Rolim Neto
Keyword(s):  
Mental Health ◽  
Sexual Abuse ◽  
Child Maltreatment ◽  
Childhood Maltreatment ◽  
Emotional Abuse ◽  
Suicide Attempts ◽  
Mental Health Problems ◽  
Meta Analysis ◽  
Physical And Mental Health ◽  
Increased Risk

Child maltreatment has serious consequences, including increasing an individual's risk of physical and mental health problems across their life course. Objective: Here we show that there  is an important public health message to focus, not only on approaches that prevent or detect childhood maltreatment, but also to explore methods of prevention and detection of mental ill health. Results: The study Childhood maltreatment and adult suicidality: a comprehensive systematic review with meta-analysis (2019) showed that all different types of childhood maltreatment including sexual abuse [odds ratio (OR) 3.17, 95% confidence interval (CI) 2.76–3.64], physical abuse (OR 2.52, 95% CI 2.09–3.04) and emotional abuse (OR 2.49, 95% CI 1.64–3.77) were associated with two- to three-fold increased risk for suicide attempts. Conclusion: It is important to highlight emotional violence may actually be more powerful than physical and sexual abuse in its impact on adolescent suicide behaviors in low- and middle-income countries. Keywords: Child Maltreatment; Mental Health; Prevention.

scholarly journals Transforming Obesity Prevention for CHILDren (TOPCHILD) Collaboration: protocol for a systematic review with individual participant data meta-analysis of behavioural interventions for the prevention of early childhood obesity

2020 ◽  
Author(s):  
Kylie E Hunter ◽  
Brittany J Johnson ◽  
Lisa Askie ◽  
Rebecca K Golley ◽  
Louise A Baur ◽  
...  
Keyword(s):  
Early Childhood ◽  
Childhood Obesity ◽  
Obesity Prevention ◽  
Meta Analysis ◽  
Individual Participant Data ◽  
Behavioural Interventions ◽  
Analysis Methodology ◽  
Individual Participant ◽  
Early Childhood Obesity ◽  
Overall Effectiveness

ABSTRACTIntroductionBehavioural interventions in early life appear to show some effect in reducing childhood overweight and obesity. However, uncertainty remains regarding their overall effectiveness, and whether effectiveness differs among key subgroups. These evidence gaps have prompted an increase in very early childhood obesity prevention trials worldwide. Combining the individual participant data (IPD) from these trials will enhance statistical power to determine overall effectiveness and enable examination of intervention-covariate interactions. We present a protocol for a systematic review with IPD meta-analysis to evaluate the effectiveness of obesity prevention interventions commencing antenatally or in the first year after birth, and to explore whether there are differential effects among key subgroups.Methods and analysisSystematic searches of Medline, Embase, CENTRAL, CINAHL, PsycInfo, and trial registries for all ongoing and completed randomised controlled trials evaluating behavioural interventions for the prevention of early childhood obesity have been completed up to March 2020 and will be updated annually to include additional trials. Eligible trialists will be asked to share their IPD; if unavailable, aggregate data will be used where possible. An IPD meta-analysis and a nested prospective meta-analysis (PMA) will be performed using methodologies recommended by the Cochrane Collaboration. The primary outcome will be body mass index (BMI) z-score at age 24 +/- 6 months using World Health Organisation Growth Standards, and effect differences will be explored among pre-specified individual and trial-level subgroups. Secondary outcomes include other child weight-related measures, infant feeding, dietary intake, physical activity, sedentary behaviours, sleep, parenting measures and adverse events.Ethics and disseminationApproved by The University of Sydney Human Research Ethics Committee (2020/273) and Flinders University Social and Behavioural Research Ethics Committee (project no. HREC CIA2133-1). Results will be relevant to clinicians, child health services, researchers, policy-makers and families, and will be disseminated via publications, presentations, and media releases.RegistrationProspectively registered on PROSPERO: CRD42020177408STRENGTHS AND LIMITATIONS OF THIS STUDYThis will be the largest individual participant data (IPD) meta-analysis evaluating behavioural interventions for the prevention of early childhood obesity to date, and will provide the most reliable and precise estimates of early intervention effects to inform future decision-making.IPD meta-analysis methodology will enable unprecedented exploration of important individual and trial-level characteristics that may be associated with childhood obesity or that may be effect modifiers.The proposed innovative methodologies are feasible and have been successfully piloted by members of our group.It may not be possible to obtain IPD from all eligible trials; in this instance, aggregate data will be used where available, and sensitivity analyses will be conducted to assess inclusion bias.Outcome measures may be collected and reported differently across included trials, potentially increasing imprecision; however, we will harmonise available data where possible, and encourage those planning or conducting ongoing trials to collect common core outcomes following prospective meta-analysis methodology.

Maternal diet in pregnancy and child's respiratory outcomes: an individual participant data meta-analysis of 18 000 children

2021 ◽  
pp. 2101315
Author(s):  
Sara M. Mensink-Bout ◽  
Evelien R. van Meel ◽  
Johan C. de Jongste ◽  
Isabella Annesi-Maesano ◽  
Adrien M. Aubert ◽  
...  
Keyword(s):  
Respiratory Diseases ◽  
Meta Analysis ◽  
Maternal Diet ◽  
Dash Score ◽  
Individual Participant Data ◽  
Z Score ◽  
Increased Risk ◽  
Individual Participant ◽  
Quality Diet ◽  
Respiratory Outcomes

RationaleSevere fetal malnutrition has been related to an increased risk of respiratory diseases later in life, but evidence for the association of a suboptimal diet during pregnancy with respiratory outcomes in childhood is conflicting. We aimed to examine whether a pro-inflammatory or low-quality maternal diet during pregnancy was associated with child's respiratory health.MethodsWe performed an individual participant meta-analysis among 18 326 mother-child pairs from seven European birth cohorts. Maternal pro-inflammatory and low-quality diet were estimated by energy-adjusted Dietary Inflammatory Index (E-DIITM) and Dietary Approaches to Stop Hypertension (DASH) scores. Preschool wheezing and school-age asthma were measured by questionnaires and lung function by spirometry.ResultsAfter adjustment for lifestyle and sociodemographic factors, we observed that a higher maternal E-DII score (a more pro-inflammatory diet) during pregnancy was associated only with a lower FVC in children (Z-score difference (95% confidence interval (CI)): −0.05 (−0.08, −0.02), per IQR increase). No linear associations of the maternal E-DII or DASH score with child's wheezing or asthma were observed. When exploratively examining the extremes, a very low DASH score (<10th percentile) (a very low dietary quality) was associated with an increased risk of preschool wheezing and a low FEV1/FVC (z-score <−1.64) (OR (95% CI) 1.20 (1.06, 1.36), 1.40 (1.06, 1.85), compared to ≥10th percentile), with corresponding population attributable risk fractions of 1.7% and 3.3%.ConclusionMain results from this individual participant data meta-analysis do not support the hypothesis that maternal pro-inflammatory or low-quality diet in pregnancy are related to respiratory diseases in childhood.

Poor prognosis associated with TERT gene alterations in meningioma is independent of the WHO classification: an individual patient data meta-analysis

2020 ◽  
Vol 91 (4) ◽  
pp. 378-387 ◽  
Author(s):  
Christian Mirian ◽  
Anne Katrine Duun-Henriksen ◽  
Tareq Juratli ◽  
Felix Sahm ◽  
Sabine Spiegl-Kreinecker ◽  
...  
Keyword(s):  
Who Classification ◽  
Meta Analysis ◽  
Incidence Rates ◽  
Who Grade ◽  
Risk Of Recurrence ◽  
Increased Risk ◽  
Individual Participant ◽  
Registration Number ◽  
Meta Analyses ◽  
Gene Alterations

BackgroundTERT gene alterations (TERT-alt) have been linked to increased risk of recurrence in meningiomas, whereas the association to mortality largely remain incompletely investigated. As incongruence between clinical course and WHO grade exists, reliable biomarkers have been sought.MethodsWe applied the Preferred Reporting Items for Systematic Review and Meta-Analyses of individual participant data Statement. We compiled data from eight studies and allocated patients to TERT-alt (n=59) or TERT promoter wild-type (TERTp-wt; n=618). We compared the two groups stratified for WHO grades as: incidence rates, survival probabilities and cumulative recurrences. We estimated the effects of WHO grade, age at diagnosis and sex as HRs.ResultsTERT-alt occurred in 4.7%, 7.9% and 15.4% of WHO-I/WHO-II/WHO-III meningiomas, respectively. The median recurrence-free survival was 14 months for all TERT-alt patients versus 101 months for all TERTp-wt patients. The HR for TERT-alt was 3.74 in reference to TERTp-wt. For all TERT-alt patients versus all TERTp-wt patients, the median overall survival was 58 months and 160 months, respectively. The HR for TERT-alt was 2.77 compared with TERTp-wt. TERT-alt affected prognosis independent of WHO grades. Particularly, the recurrence rate was 4.8 times higher in WHO-I/-II TERT-alt patients compared with WHO-III TERTp-wt patients. The mortality rate was 2.7 times higher in the WHO-I and WHO-II TERT-alt patients compared with WHO-III TERTp-wt patients.ConclusionsTERT-alt is an important biomarker for significantly higher risk of recurrence and death in meningiomas. TERT-alt should be managed and surveilled aggressively. We propose that TERT-alt analysis should be implemented as a routine diagnostic test in meningioma and integrated into the WHO classification.Trial registration numberPROSPERO: CRD42018110566.

Fractures and the increased risk of suicide

2018 ◽  
Vol 100-B (6) ◽  
pp. 780-786 ◽  
Author(s):  
C-F. Chang ◽  
E. C-C. Lai ◽  
M-K. Yeh
Keyword(s):  
Mental Health Problems ◽  
Conditional Logistic Regression ◽  
Spinal Fractures ◽  
High Rate ◽  
Physical And Mental Health ◽  
Additional Risk ◽  
Never Married ◽  
Increased Risk ◽  
Contextual Setting ◽  
Control Study

Aims A high rate of suicide has been reported in patients who sustain fractures, but the association remains uncertain in the context of other factors. The aim of this study was to examine the association between fractures and the risk of suicide in this contextual setting. Patients and Methods We performed a case-control study of patients aged 40 years or older who died by suicide between 2000 and 2011. We included patients’ demographics, physical and mental health problems, and socioeconomic factors. We performed conditional logistic regression to evaluate the associations between fractures and the risk of suicide. Results We included a total of 34 794 patients who died by suicide and 139 176 control patients. We found that fractures as a homogenous group (adjusted odds ratios (aOR), 1.48; 95% confidence interval (CI) 1.43 to 1.53), and specifically pelvic (aOR 2.04; 95% CI 1.68 to 2.47) and spinal fractures (aOR 1.53; 95% CI 1.43 to 1.64), were associated with a higher risk of suicide. In addition, we found that patients who had a lower income, had never married, had lower levels of educational attainment, or had coexistent physical and mental conditions such as anxiety, mood disorders, and psychosis-related disorders had a higher risk of suicide. Conclusion Fractures, specifically those of the hip and spine, were associated with an increased risk of suicide. The findings suggest that greater clinical attention should be given to this risk in patients with fractures, especially for those with additional risk factors. Cite this article: Bone Joint J 2018;100-B:780–6.

scholarly journals Sex-specific effects of nutritional supplements in infants born early or small: protocol for an individual participant data meta-analysis (ESSENCE IPD-MA)

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e033438 ◽  
Author(s):  
Luling Lin ◽  
Caroline Crowther ◽  
Greg Gamble ◽  
Frank Bloomfield ◽  
Jane E Harding
Keyword(s):  
Meta Analysis ◽  
Ethics Committees ◽  
Postnatal Growth ◽  
High Energy ◽  
Adverse Outcomes ◽  
Individual Participant Data ◽  
Poor Growth ◽  
Intention To Treat ◽  
Increased Risk ◽  
Individual Participant

IntroductionPreterm and small for gestational age (SGA) infants are at increased risk of poor growth, disability and delayed development. While growing up they are also at increased risk of obesity, diabetes and later heart disease. The risk of such adverse outcomes may be altered by how preterm and SGA infants are fed after birth. Faltering postnatal growth is common due to failure to achieve recommended high energy and protein intakes, and thus preterm and SGA infants are often provided with supplemental nutrition soon after birth. Enhanced nutrition has been associated with improved early growth and better cognitive development. However, limited evidence suggests that faster growth may increase the risk for later adiposity, metabolic and cardiovascular disease, and that such risks may differ between girls and boys.Methods and analysisWe will search Ovid MEDLINE, Embase, Cochrane CENTRAL, Cochrane Database of Systematic Reviews, controlled-trials.com, ClinicalTrials.gov and anzctr.org.au for randomised trials that studied the effects of macronutrient supplements for preterm and SGA infants on (i) developmental and metabolic and (ii) growth outcomes after hospital discharge. The outcomes will be (i) cognitive impairment and metabolic risk (co-primary) and (ii) body mass index. Individual participant data (IPD) from all available trials will be included using an intention-to-treat approach. A one-stage procedure for IPD meta-analysis (MA) will be used, accounting for clustering of participants within studies. Exploratory subgroup analyses will further investigate sources of heterogeneity, including sex and size of infants, different timing, duration and type of supplements.Ethics and disseminationThis IPD-MA is approved by the University of Auckland Human Participants Ethics Committee (reference number: 019874). Individual studies have approval from relevant local ethics committees. Results will be disseminated in a peer-reviewed journal and presented at international conferences.PROSPERO registration numberCRD42017072683

Long working hours and stroke among employees in the general workforce of Denmark

2017 ◽  
Vol 46 (3) ◽  
pp. 368-374 ◽  
Author(s):  
Harald Hannerz ◽  
Karen Albertsen ◽  
Hermann Burr ◽  
Martin Lindhardt Nielsen ◽  
Anne Helene Garde ◽  
...  
Keyword(s):  
Ischaemic Stroke ◽  
Labour Force ◽  
Economic Status ◽  
Meta Analysis ◽  
Working Hours ◽  
Haemorrhagic Stroke ◽  
Long Working Hours ◽  
Increased Risk ◽  
Individual Participant ◽  
Rate Ratios

Aims: A systematic review and meta-analysis have found that long working hours were prospectively associated with an increased risk of overall stroke. The primary aim of the present study was to test if this finding could be reproduced in a sample that has been randomly selected from the general workforce of Denmark. A secondary aim was to estimate the association for haemorrhagic and ischaemic stroke separately. Methods: Individual participant data on 20- to 64-year-old employees were drawn from the Danish Labour Force Survey, 1999–2013, and linked to data on socio-economic status (SES), migrations, hospitalisations and deaths from national registers. The participants were followed from the time of the interview until the end of 2014. Poisson regression was used to estimate age-, sex- and SES-adjusted rate ratios for stroke as a function of weekly working hours. Results: With 35–40 working hours per week as reference, the estimated rate ratios for overall stroke were 0.97 (95% confidence interval (CI) 0.83–1.13) for 41–48 working hours, 1.10 (95% CI 0.86–1.39) for 49–54 working hours and 0.89 (95% CI 0.69–1.16) for ≥55 working hours. The estimated rate ratios per one category increase in working hours were 0.99 (95% CI 0.93–1.06) for overall stroke, 0.96 (95% CI 0.88–1.05) for ischaemic stroke and 1.15 (95% CI 1.02–1.31) for haemorrhagic stroke. Conclusions: Our analysis does not support the hypothesis that long working hours are associated with increased rates of overall stroke. It suggests, however, that long working hours might be associated with increased rates of haemorrhagic stroke.

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