Truancy and teenage pregnancy in English adolescent girls: can we identify those at risk?

BACKGROUND: Truancy has been linked to risky sexual behaviours in teenagers. However, no studies in England have examined the association between truancy and teenage pregnancy, and the use of truancy as a marker of teenagers at risk of pregnancy. METHODS: Using logistic regression, we investigated the association between truancy at age 15 and the likelihood of teenage pregnancy by age 19 among 3837 female teenagers who participated in the Longitudinal Study of Young People of England. We calculated the areas under the ROC curves of four models to determine how useful truancy would be as a marker of future teenage pregnancy. RESULTS: Truancy showed a dose-response association with teenage pregnancy after adjusting for ethnicity, educational intentions at age 16, parental socioeconomic status and family composition ('several days at a time' versus 'none', odds ratio 3.48 95% confidence interval 1.90-6.36, P < 0.001). Inclusion of risk behaviours improved the accuracy of predictive models only marginally (area under the ROC curve 0.76 full model versus 0.71 sociodemographic characteristics only). CONCLUSIONS: Truancy is independently associated with teenage pregnancy among English adolescent girls. However, the discriminatory powers of models were low, suggesting that interventions addressing the whole population, rather than targeting high-risk individuals, might be more effective in reducing teenage pregnancy rates.The work by Y.Z. is supported by an Academic Clinical Fellowship awarded by Health Education East of England (HEEoE). The work by D.I.P. is supported by the Economic and Social Science Research Council (ESRC) Grant ES.J004898.1.This is the final published version. It first appeared at http://dx.doi.org/10.1093/pubmed/fdv02

Development and evaluation of an online tool for management of overweight children in primary care: a pilot study.

OBJECTIVE: To explore the acceptability of implementing an online tool for the assessment and management of childhood obesity (Computer-Assisted Treatment of CHildren, CATCH) in primary care. DESIGN AND SETTING: An uncontrolled pilot study with integral process evaluation conducted at three general practices in northwest London, UK (November 2012-April 2013). PARTICIPANTS: Families with concerns about excess weight in a child aged 5-18 years (n=14 children). INTERVENTION: Families had a consultation with a doctor or nurse using CATCH, which assessed child weight status, cardiometabolic risk and risk of emotional and behavioural difficulties and provided personalised lifestyle advice. Families and practitioners completed questionnaires to assess the acceptability and usefulness of the consultation, and participated in semistructured interviews which explored user experiences. OUTCOME MEASURES: The primary outcome was family satisfaction with the tool-assisted consultation. Secondary outcomes were practitioners' satisfaction, and acceptability and usefulness of the intervention to families and practitioners. RESULTS: The majority of families (86%, n=12) and all practitioners (n=4) were satisfied with the consultation. Participants reported that the tool was easy to use, the personalised lifestyle advice useful and the use of visual aids beneficial. Families and practitioners identified a need for practical, structured support for weight management following the consultation. CONCLUSIONS: The results of this pilot study indicate that an online tool for assessment and management of childhood obesity can be implemented in primary care, and is acceptable to patients, families and practitioners. Further development and evaluation of the tool is warranted

The language of malaria in Abui: An interdisciplinary investigation of healthcare practices in Alor, Eastern Indonesia

We report on an interdisciplinary collaboration between public health experts, linguists, and botanists which seeks to better understand indigenous perspectives on malaria among the Abui [abz] speaking communities of Alor Island, Eastern Indonesia. Malaria is endemic in Alor and is highly resistant to common conventional treatment regimens (Sutanto et al. 2009). There is a low rate of compliance with modern malaria treatments, and a correspondingly high reliance on traditional treatment methods (Krentel 2008). Our research attempts to understand traditional knowledge of malaria in Abui and its relevance to modern healthcare. We analyze a corpus of unstructured interviews concerning health-related problems in Abui in order to better understand the conceptualization of disease (Forster 1976). This includes the systematic study of metaphor (Author 2016), sequencing of symptom descriptions (Author 2016), symptom-based indigenous classification of malaria, an inventory of traditional health-protecting practices, and an inventory of medical plants. The plant terminology reveals a syncretism between terms referring to diseases and the plants which either treat or cause those diseases. For example, the term takaya denotes both the ti plant (Cordyline fruticosa) and a severe form of malaria (Plasmodium falciparum). The leaves of the ti plant takaya are tied onto valuable trees such as candlenut, areca palm, and jackfruit to create a protective spell which wards off theft of the fruits or nuts of that tree. Transgressing this protection by taking the fruits or nuts without permission will cause the transgressor to suffer the takaya disease. The existence of supernatural causes may go unnoticed when interviews are conducted in Indonesian, the national language closely associated with modernity. However, the pervasiveness of plant-disease syncretism within Abui belies the continuing significance of traditional beliefs regarding disease. The collaborative methodology described here shows great promise for improving our understanding of the conceptualization of malaria in Abui and thus increasing treatment efficacy for this disease. Moreover, this approach provides a platform for documentary linguistics which includes a high level of community engagement. The healthcare interviews yield a culturally significant corpus of spontaneous speech which also serves as an independent knowledge base to evaluate the reliability and accuracy of ethnobotanical research. Finally, we suggest several ways in which our approach can be applied to future healthcare research in other domains and with other communities. References Author. 2016. The Pragmatics Behind the Medical and Health Knowledge in Alor: An Understanding of how disease is conceptualized in the Abui language. Honors thesis. Nanyang Technological University, Singapore. Du Bois, Cora. 1944. The People of Alor: a social-psychological study of an East Indian island. Minnesota: The University of Minnesota Press Forster, George M. 1976. Disease Etiologies in Non-Western Medical Systems. American Anthropologist 78(4): 773-782. Krentel, Alison. 2008. Why do individuals comply with mass drug administration for lymphatic filariasis? A case study from Alor District, Indonesia. PhD dissertation. London School of Hygiene & Tropical Medicine. Sutanto, I. Nurhayati, S. S., Manoempil, P., Baird, J.K. 2009. Resistance to Choloroquine by Plasmodium vivax at Alor in the Lesser Sundas Archipelago in Eastern Indonesia. The American Society of Tropical Medicine and Hygiene, 81(2), 338-342. Author. 2016. The Semantics of Complex Sentences in the Discourse of Health and Diseases: A Case Study in Abui. Honors thesis. Nanyang Technological University, Singapore

A cluster randomized controlled trial for assessing POC-CCA test based praziquantel treatment for schistosomiasis control in pregnant women and their young children: study protocol of the freeBILy clinical trial in Madagascar.

BACKGROUND: Mass drug administration (MDA) of praziquantel is one of the main control measures against human schistosomiasis. Although there are claims for including pregnant women, infants and children under the age of 5 years in high-endemic regions in MDA campaigns, they are usually not treated without a diagnosis. Diagnostic tools identifying infections at the primary health care centre (PHCC) level could therefore help to integrate these vulnerable groups into control programmes. freeBILy (fast and reliable easy-to-use-diagnostics for eliminating bilharzia in young children and mothers) is an international consortium focused on implementing and evaluating new schistosomiasis diagnostic strategies. In Madagascar, the study aims to determine the effectiveness of a test-based schistosomiasis treatment (TBST) strategy for pregnant women and their infants and children up until the age of 2 years. METHODS: A two-armed, cluster-randomized, controlled phase III trial including 5200 women and their offspring assesses the impact of TBST on child growth and maternal haemoglobin in areas of medium to high endemicity of Schistosoma mansoni. The participants are being tested with the point of care-circulating cathodic antigen (POC-CCA) test, a commercially available urine-based non-invasive rapid diagnostic test for schistosomiasis. In the intervention arm, a POC-CCA-TBST strategy is offered to women during pregnancy and 9 months after delivery, for their infants at 9 months of age. In the control arm, study visit procedures are the same, but without the POC-CCA-TBST procedure. All participants are being offered the POC-CCA-TBST 24 months after delivery. This trial is being integrated into the routine maternal and child primary health care programmes at 40 different PHCC in Madagascar's highlands. The purpose of the trial is to assess the effectiveness of the POC-CCA-TBST for controlling schistosomiasis in young children and mothers. DISCUSSION: This trial assesses a strategy to integrate pregnant women and their children under the age of 2 years into schistosomiasis control programmes using rapid diagnostic tests. It includes local capacity building for clinical trials and large-scale intervention research. TRIAL REGISTRATION: Pan-African Clinical Trial Register PACTR201905784271304. Retrospectively registered on 15 May 2019

Study population characteristics, stratified by urban and rural FSW populations (<i>n</i> = 310), 2007.

<p>Notes:</p>(a)<p><i>P</i> values obtained from Chi-square and Mann-Whitney U test.</p>(b)<p>Median age and inter-quartile range.</p

Unadjusted and adjusted odds ratios (ORs) for consistent condom use with clients, 2007.

(a)<p>The category ‘rural direct non-venue-based FSWs’ was excluded from this model due to its small sample size (n = 11). A model, which included this sub-group, resulted in large estimates signalling sparse-data bias within this categorical stratum, before and after adjustment (unadjusted OR: 1.9E⁻⁹ 95% CI 0 - ∞, p = 0.999; adjusted OR: 2.6E⁻⁹ 95% CI 0 - ∞, p = 0.999). This made it difficult to draw any definitive conclusions. Further, given the detail of the ethnography, there is reason to suspect that the rural non-venue-based FSW sample is not representative in statistical terms.</p>(b)<p>The categories divorced/separated and widowed were aggregated due to their similarity in the direction of effect.</p>(c)<p>1 USD = ca. IDR 9, 560.00 on 6 Sept 2012 according to <a href="http://www.xe.com/ucc/convert/?Amount=1&From=USD&To=IDR" target="_blank">http://www.xe.com/ucc/convert/?Amount=1&From=USD&To=IDR</a>. Here converted from IDR*1000 to USD (rounded up to IDR 10 000 per 1 USD).</p

EDDi - 3 Reporting Sheet (Facilitator's Version): An Epidemic of Haemolytic Uraemic Syndrome in Hamburg

EDDi Serious Game - An Epidemic of Haemolytic Uraemic Syndrome in Hamburg Summary: Building on a problem-based self-study approach, EDDi participants will be introduced to the principles and practices of infectious disease epidemiology as well as concepts related to the investigation of disease outbreaks, with particular focus on: Describing infectious disease events and evaluating local outbreak scenarios Learning about basic methods of epidemiological outbreak investigation, study designs, and tools of epidemiology (e.g., epidemiological curves, outbreak maps, technical terms) Interpreting and recognizing associations between outbreak events and relevant influencing factors by applying basic techniques of infectious disease epidemiology (especially descriptive methods) Making informed decisions in outbreak investigation based on epidemiological evidence Extra: Getting to know the structure of the German disease surveillance and reporting system as well as background information on the Hanseatic city of Hamburg Preparation of the Serious Game for Application in Teaching and Capacity Strengthening Resources 1 EDDi Serious Game - for Windows /OR/ Web Player - ***COMING SOON*** 2 EDDi Outbreak Reporting Sheet: Evaluation sheet for discussing the game performance in class 3 EDDi Outbreak Reporting Sheet (Facilitator's Version): Guide for facilitators including solutions Approximate time (classroom teaching set-up) Serious Game approx. 2.5-3 hours (estimate) Completion of Outbreak Summary Report approx. 20 minutes (estimate) Joint Discussion for Follow-Up approx. 30 minutes (estimate) Welcome Tutorial and Epidemiological Cheat Sheet As the EDDi Serious Game (Windows / Web Player) requires a basic understanding of infectious disease epidemiology concepts and terminology, refreshing some background knowledge through the EDDi Welcome Tutorial is recommended, either individually or in small groups. There is a total of six educational videos to prepare for the different tasks of the exercise. The tutorial can be given to students as preparatory homework and could be further supplemented with additional questions. In addition, students may be advised to familiarize themselves with the Epidemiology Cheat Sheet and bring a copy. Materials needed Ensure that students are able to access the EDDi Serious Game (Windows / Web Player) and that devices fulfill the game's system requirements (see System Requirements below). In preparation for the final follow-up discussion, each student should have a printout of the EDDi Reporting Sheet. A calculator is needed for some of the tasks. In addition, headphones can be recommended to students, though the sound in the game is not essential for completing the assignment. System Requirements The Serious Game is available for Windows (.exe, all files from the zip folder are required for the game to run!) and via web browser (Unity WebGL Player). It is optimized for widescreen (16:9) and standard resolution 1920x1080 pixels. https://docs.unity3d.com/Manual/system-requirements.html Operating System | Windows 7 SP1+, 8, 10, 64-bit versions only GPU | Graphic card supporting DX10 (Shader-Modell 4.0) RAM | Minimum 4 GB storage Workflow #1 Make sure you have completed all preparations and all printouts are available. #2 Before starting the EDDi Serious Game (Windows / Web Player) exercise, explain the overall outline of the exercise (learning objectives, resources needed, estimated time to complete the game) and the game's system requirements to the students. The Serious Game can either be used in class or given to students as a take-home assignment. In either case, ensure that students have access to the game. Since it is a Single Player Game, students may tackle the outbreak alone or in a small group together with their peers. The game itself will guide them through its storyline, tasks, and reference materials. But beware: There’s currently no option to save any game progress. If the player quits EDDi, it crashes, or their device accidentally loses power, they will be reset to the start of the mission. If students play EDDi in a small group, remind them to take enough time to carefully discuss and evaluate their findings and clues in the group. #3 Throughout the game, students will encounter frequent pointers on how they're performing. If the Serious Game is used in face-to-face classroom teaching, you may also assist with questions. Make sure to keep an eye on the time! #4 At the end of the Serious Game exercise (at home or in the classroom), students are to fill out an EDDi Reporting Sheet. The report should serve as the basis for a final joint discussion in the cohort. The Serious Game exercise should therefore close with a face-to-face outbreak wrap-up and exchange of findings and experiences, moderated by the facilitator via the EDDi Reporting Sheet-Facilitator's Version (approx. 30 minutes). Students can also evaluate their final game statistics using the Facilitator's Version. To learn more about the real outbreak event, further reading materials can be found in the EDDi Read.Me and shared with the class. Extra: Being a third-party-funded project, EDDi was completed in September 2023. There is no continuing technical support. If you would like to revise, rewrite, or build a new narrative upon this case study, all materials are available under an open license.This resource is published under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/). The license's terms and conditions for further use and distribution apply. For further information on EDDi visit https://linktr.ee/e.d.d.i