Do men avoid seeking medical advice? A register-based analysis of gender-specific changes in primary healthcare use after first hospitalisation at ages 60+ in Denmark

The work was supported by the US National Institute of Health (P01AG031719, R01AG026786, and 2P01AG031719), the VELUX Foundation and the Max Planck Society within the framework of the project “On the edge of societies: New vulnerable populations, emerging challenges for social policies and future demands for social innovation. The experience of the Baltic Sea States (2016-2021)”.Background  It remains unclear whether women’s greater primary healthcare use reflects a lower treatment-seeking threshold or a health disadvantage. We address this question by studying primary healthcare use surrounding a major health shock. Methods  This cohort study utilises routinely-collected healthcare data covering the Danish population aged 60+ years between 1996 and 2011. Using a hurdle model, we investigate levels of non-use and levels of primary healthcare use before and after first inpatient hospitalisation for stroke, myocardial infarction (MI), chronic obstructive pulmonary disease (COPD) and gastrointestinal cancers (GIC). Results  Before hospitalisation, irrespective of cause, men were more likely than women to be non-users of primary healthcare (OR (95% CI): stroke 1.802 (1.731 to 1.872); MI 1.841 (1.760 to 1.922); COPD 2.160 (2.028 to 2.292); GIC 1.609 (1.525 to 1.693)). Men who were users had fewer primary healthcare contacts than women (proportional change (eβ) (95% CI): stroke 0.821 (0.806 to 0.836); MI 0.796 (0.778 to 0.814); COPD 0.855 (0.832 to 0.878); GIC 0.859 (0.838 to 0.881)). Following hospitalisation, changes in the probability of being a non-user (OR (95% CI): stroke 0.965 (0.879 to 1.052); MI 0.894 (0.789 to 0.999); COPD 0.755 (0.609 to 0.900); GIC 0.895 (0.801 to 0.988)) and levels of primary healthcare use (eβ (95% CI): stroke 1.113 (1.102 to 1.124); MI 1.112 (1.099 to 1.124); COPD 1.078 (1.063 to 1.093); GIC 1.097 (1.079 to 1.114)) were more pronounced among men. Gender differences widened after accounting for survival following hospitalisation. Conclusion  Women’s consistently higher levels of primary healthcare use are likely to be explained by a combination of a lower treatment-seeking threshold and a health disadvantage resulting from better survival in bad health.Publisher PDFPeer reviewe

Is who you ask important? Concordance between survey and registry data on medication use among self- and proxy-respondents in the longitudinal study of aging Danish twins and the Danish 1905-cohort study

This work was supported by the U.S. National Institute of Health (P01AG031719, R01AG026786 and 2P01AG031719), the VELUX Foundation, and the Max Planck Society within the framework of the project “On the edge of societies: New vulnerable populations, emerging challenges for social policies and future demands for social innovation. The experience of the Baltic Sea States (2016–2021).”Background This study investigates the accuracy of the reporting of medication use by proxy- and self-respondents, and it compares the prognostic value of the number of medications from survey and registry data for predicting mortality across self- and proxy-respondents. Methods The study is based on the linkage of the Longitudinal Study of Aging Danish Twins and the Danish 1905–Cohort Study with the Danish National Prescription Registry. We investigated the concordance between survey and registry data, and the prognostic value of medication use when assessed using survey and registry data, to predict mortality for self- and proxy-respondents at intake surveys. Results Among self-respondents, the agreement was moderate (κ = 0.52–0.58) for most therapeutic groups, whereas among proxy-respondents, the agreement was low to moderate (κ = 0.36–0.60). The magnitude of the relative differences was, generally, greater among proxies than among self-respondents. Each additional increase in the total number of medications was associated with 7%–8% mortality increase among self- and 4%–6% mortality increase among proxy-respondents in both the survey and registry data. The predictive value of the total number of medications estimated from either data source was lower among proxies (c-statistic = 0.56–0.58) than among self-respondents (c-statistic = 0.74). Conclusions The concordance between survey and registry data regarding medication use and the predictive value of the number of medications for mortality were lower among proxy- than among self-respondents.Publisher PDFPeer reviewe

Quantifying sources of variability in infancy research using the infant-directed-speech preference

Psychological scientists have become increasingly concerned with issues related to methodology and replicability, and infancy researchers in particular face specific challenges related to replicability: For example, high-powered studies are difficult to conduct, testing conditions vary across labs, and different labs have access to different infant populations. Addressing these concerns, we report on a large-scale, multisite study aimed at (a) assessing the overall replicability of a single theoretically important phenomenon and (b) examining methodological, cultural, and developmental moderators. We focus on infants’ preference for infant-directed speech (IDS) over adult-directed speech (ADS). Stimuli of mothers speaking to their infants and to an adult in North American English were created using seminaturalistic laboratory-based audio recordings. Infants’ relative preference for IDS and ADS was assessed across 67 laboratories in North America, Europe, Australia, and Asia using the three common methods for measuring infants’ discrimination (head-turn preference, central fixation, and eye tracking). The overall meta-analytic effect size (Cohen’s d) was 0.35, 95% confidence interval = [0.29, 0.42], which was reliably above zero but smaller than the meta-analytic mean computed from previous literature (0.67). The IDS preference was significantly stronger in older children, in those children for whom the stimuli matched their native language and dialect, and in data from labs using the head-turn preference procedure. Together, these findings replicate the IDS preference but suggest that its magnitude is modulated by development, native-language experience, and testing procedure. (This project has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 798658.

A multilab study of bilingual infants: Exploring the preference for infant-directed speech

From the earliest months of life, infants prefer listening to and learn better from infant-directed speech (IDS) compared with adult-directed speech (ADS). Yet IDS differs within communities, across languages, and across cultures, both in form and in prevalence. This large-scale, multisite study used the diversity of bilingual infant experiences to explore the impact of different types of linguistic experience on infants’ IDS preference. As part of the multilab ManyBabies 1 project, we compared preference for North American English (NAE) IDS in lab-matched samples of 333 bilingual and 384 monolingual infants tested in 17 labs in seven countries. The tested infants were in two age groups: 6 to 9 months and 12 to 15 months. We found that bilingual and monolingual infants both preferred IDS to ADS, and the two groups did not differ in terms of the overall magnitude of this preference. However, among bilingual infants who were acquiring NAE as a native language, greater exposure to NAE was associated with a stronger IDS preference. These findings extend the previous finding from ManyBabies 1 that monolinguals learning NAE as a native language showed a stronger IDS preference than infants unexposed to NAE. Together, our findings indicate that IDS preference likely makes similar contributions to monolingual and bilingual development, and that infants are exquisitely sensitive to the nature and frequency of different types of language input in their early environments

A multi-element psychosocial intervention for early psychosis (GET UP PIANO TRIAL) conducted in a catchment area of 10 million inhabitants: study protocol for a pragmatic cluster randomized controlled trial

Multi-element interventions for first-episode psychosis (FEP) are promising, but have mostly been conducted in non-epidemiologically representative samples, thereby raising the risk of underestimating the complexities involved in treating FEP in 'real-world' services

Is Who you Ask Important? Concordance Between Survey and Registry Data on Medication Use Among Self- and Proxy-Respondents in the Longitudinal Study of Aging Danish Twins and the Danish 1905-Cohort Study

Oksuzyan A, Sauer T, Gampe J, et al. Is Who you Ask Important? Concordance Between Survey and Registry Data on Medication Use Among Self- and Proxy-Respondents in the Longitudinal Study of Aging Danish Twins and the Danish 1905-Cohort Study. The Journals of Gerontology: Series A. 2019;74(5):742-747

The development of gaze following in monolingual and bilingual infants: A multi-lab study

Determining the meanings of words requires language learners to attend to what other people say. However, it behooves a young language learner to simultaneously attend to what other people attend to, for example, by following the direction of their eye gaze. Sensitivity to cues such as eye gaze might be particularly important for bilingual infants, as they encounter less consistency between words and objects than monolinguals, and do not always have access to the same word learning heuristics (e.g., mutual exclusivity). In a pre-registered study, we tested the hypothesis that bilingual experience would lead to a more pronounced ability to follow another’s gaze. We used the gaze-following paradigm developed by Senju & Csibra (2008) to test a total of 93 6–9 month-old and 229 12–15 month-old monolingual and bilingual infants, in 11 labs located in 8 countries. Monolingual and bilingual infants showed similar gaze-following abilities, and both groups showed age-related improvements in speed, accuracy, frequency and duration of fixations to congruent objects. Unexpectedly, bilinguals tended to make more frequent fixations to onscreen objects, whether or not they were cued by the actor. These results suggest that gaze sensitivity is a fundamental aspect of development that is robust to variation in language exposure

The development of gaze following in monolingual and bilingual infants: A multi-lab study

Determining the meanings of words requires language learners to attend to what other people say. However, it behooves a young language learner to simultaneously attend to what other people attend to, for example, by following the direction of their eye gaze. Sensitivity to cues such as eye gaze might be particularly important for bilingual infants, as they encounter less consistency between words and objects than monolinguals, and do not always have access to the same word learning heuristics (e.g., mutual exclusivity). In a pre-registered study, we tested the hypothesis that bilingual experience would lead to a more pronounced ability to follow another’s gaze. We used the gaze-following paradigm developed by Senju and Csibra (2008) to test a total of 93 6–9 month-old and 229 12–15 month-old monolingual and bilingual infants, in 11 labs located in 8 countries. Monolingual and bilingual infants showed similar gaze-following abilities, and both groups showed age-related improvements in speed, accuracy, frequency and duration of fixations to congruent objects. Unexpectedly, bilinguals tended to make more frequent fixations to onscreen objects, whether or not they were cued by the actor. These results suggest that gaze sensitivity is a fundamental aspect of development that is robust to variation in language exposure

The Development of gaze following in monolingual and bilingual infants: A multi‐laboratory study

Determining the meanings of words requires language learners to attend to what other people say. However, it behooves a young language learner to simultaneously encode relevant non-verbal cues, for example, by following the direction of their eye gaze. Sensitivity to cues such as eye gaze might be particularly important for bilingual infants, as they encounter less consistency between words and objects than monolingual infants, and do not always have access to the same word-learning heuristics (e.g., mutual exclusivity). In a preregistered study, we tested the hypothesis that bilingual experience would lead to a more pronounced ability to follow another's gaze. We used a gaze-following paradigm developed by Senju and Csibra (Current Biology, 18, 2008, 668) to test a total of 93 6- to 9-month-old and 229 12- to 15-month-old monolingual and bilingual infants, in 11 laboratories located in 8 countries. Monolingual and bilingual infants showed similar gaze-following abilities, and both groups showed age-related improvements in speed, accuracy, frequency, and duration of fixations to congruent objects. Unexpectedly, bilinguals tended to make more frequent fixations to on-screen objects, whether or not they were cued by the actor. These results suggest that gaze sensitivity is a fundamental aspect of development that is robust to variation in language exposure.Individual participatin laboratories acknowledge funding support from: the Natural Sciences and Engineering Research Council of Canada (402470-2011; 2018-04390); the National Science Foundation (BCS-155719); the UK Economic and Social Research Council (ESRC ES/L008955/1); the European Research Council Advanced Grant, UNDER CONTROL (323961); the European Research Council Marie Sklodowska-Curie grant (798658); the Leverhulme Trust (ECF-2015-009); the National Institute of Child Health and Human Development (R01HD083312); the European Research Council Synergy Grant (SOMICS 609819); the Early Career Research Grant & Start-up Grant, Western Sydney University; Research Manitoba University of Manitoba, Children's Hospital Research Institute of Manitoba; and the ODPRT funds, National University of Singapore