National Dataset Research Articles

The Impact of Early Childhood Life Adversity on Peripubertal Accelerated Epigenetic Aging and Psychopathology

To examine longitudinal associations between early life threat and deprivation on epigenetic age acceleration at ages 9 and 15 years, and to examine associations of age acceleration on later internalizing and externalizing symptoms. The study examines a large (n= 2,039) and racially diverse (Black/African American= 44%, Latino= 18%, White= 5%) sample from a national dataset. Epigenetic age acceleration was estimated using the pediatric buccal epigenetic clock. Early life threat and deprivation were measured using composites from the Parent-Child Conflict Tactics Scale and county-level violent and property crime rate data. Internalizing and externalizing symptoms came from parent-reported Child Behavior Checklist. Path analysis models examined associations of threat and deprivation at age 3 years on epigenetic age acceleration at ages 9 and 15. Experiences of threat were further broken down into threat experienced in the home and in the community. Home threat experienced at age 3 years predicted age acceleration at 9 and 15, and community threat experienced at 3 predicted age acceleration at 15, but not at 9. Deprivation was not a significant predictor of accelerated aging. Age acceleration at age 9 predicted externalizing, but not internalizing, symptoms at age 15. Community threat had a direct effect on externalizing. No association emerged with internalizing. Findings revealed that threat, not deprivation, was predictive of age acceleration, demonstrating support for this pattern longitudinally, using an epigenetic clock that is accurate in children. The findings provide critical nuance to the examination of threat, and highlight associated risks and possible intervention points for externalizing symptoms.

The changing shape of English general practice: a retrospective longitudinal study using national datasets describing trends in organisational structure, workforce and recorded appointments

ObjectiveTo describe trends in the organisational structure, workforce and recorded appointments by role in English general practice.DesignRetrospective longitudinal study.SettingEnglish general practice.Data sources and participantsNHS England, Office for Health Improvement and...

Sustainable Development Goals Need for India to Refocus on Measurement and Monitoring

The first and most important Global Goal set in the Charter of Sustainable Development Goals (SDGs), adopted by the United Nations in 2015, is “NO POVERTY.” Countries estimate the extremely poor population based on the International Poverty Level (IPL), which uses Global Purchase power parities (PPP) set by the World Bank International Comparison program. Some claims state that India has made substantial progress in fighting extreme poverty during the last few decades. Published data shows there is no headcount below the National Poverty line. This paper attempts to study the relevance of the national statistical data sets on the limits and levels for the poverty line in India as against the international poverty level, taking into consideration of the Purchasing Power Index, Gross GDP, and per capita GDP, Gross National Income, and Per capita Income, minimum wedge regulations, and the critical parameters for the Hunger Index.

The impact of COVID-19 vaccine spring boosters on COVID-19 hospital admissions in England 2022/23

In the spring of 2022 and 2023 COVID-19 vaccine boosters were recommended for those aged ≥75 years in England as well as those in an immunosuppression risk group. The aim was to reduce severe COVID-19 disease in these groups. The large difference in coverage between those above and below age 75 years was the basis for applying an age-discontinuity approach for measuring the impact of vaccination on COVID-19 hospitalisations in both spring 2022 and 2023. Hospitalisations in individuals positive by PCR for COVID-19 were obtained from the national secondary user service hospital dataset. The ratio of hospital counts by each year of age in 8-week periods after compared to before the roll out was modelled using negative binomial regression to estimate the discontinuity at age 75 years. A clear discontinuity was seen at age 75 years of 17.0% (95% CI: 6.1%-26.6%) in 2022 and 18.0% (3.3%-30.4%) in 2023. If applied to those aged ≥75 years this translates to 1302 and 418 averted hospitalisations in the 8-week period in 2022 and 2023, respectively. This study shows a clear impact of vaccination on preventing COVID-19 hospitalisations and compliments other epidemiological methods assessing the impact of COVID-19 vaccines. One way to see if the booster vaccines doses given to protect against COVID-19 disease are working is to compare hospital admissions in groups of people who were and were not eligible for the dose. In England the spring booster doses were recommended for those aged 75 years and above. We could therefore compare hospitalisations in those above this age to those just below (aged 65-74) and see if there is a step change in rates from age 74 to 75 in the time after the vaccine was given. The results showed hospitalisations were about 18% lower in the group that were eligible, which is evidence that the vaccine is protecting against severe COVID-19.

Appropriateness of Immunoglobulin M Testing for Measles, Mumps, and Rubella

IntroductionTesting for immunity to measles, mumps, and rubella should include only IgG; IgM testing is appropriate only if acute illness is suspected. The appropriateness of measles, mumps, and rubella IgM testing was evaluated in a national administrative dataset. MethodsLaboratory testing for measles, mumps, and rubella during 2019–2022 was analyzed in 2024 using HealthVerity administrative claims and laboratory data. IgG, IgM, and reverse-transcriptase polymerase chain reaction (RT-PCR) testing are described by year, demographics, and region. IgM testing was examined for appropriateness, defined as an IgM test combined with diagnostic codes indicative of acute illness. ResultsDuring 2019–2022, IgM testing represented a small proportion of serologic testing (measles: 3.3%, mumps: 2.4%, rubella: 2.1%) but appeared to be appropriately performed in only 15.4% of cases for measles, 32.8% of cases for mumps, and 10.2% of cases for rubella. IgM testing was more commonly performed for female patients, with the largest discrepancy seen for rubella (90.5% female vs 9.5% male). IgM for measles and mumps was more often performed appropriately for persons aged 0–19 years (37.6% and 60.1%) compared with persons aged 20–49 years (11.8% and 22.0%) and 50+ years (16.5% and 33.8%). ConclusionsThe majority of IgM testing for measles, mumps, and rubella during this period appeared inappropriate. Clinicians and health systems could ensure that IgG testing alone is performed when evaluating for immunity through modifications to electronic medical records and commercial laboratories could ensure that providers are able to test for IgG alone when evaluating immunity.

Impact of uncertainty in building operation patterns and electric energy demand on the design and techno-economic performance of solar photovoltaic systems in different climates

The optimal design of renewable energy systems for buildings requires accurately estimating building electric energy loads. While this energy demand highly depends on how occupants and facility managers use building systems, operation-related uncertainty is rarely accounted for in the renewable energy design workflow. This paper presents a comprehensive framework to quantify the impact of uncertainty in building operation patterns and electric demand on the techno-economic performance of grid-connected photovoltaic (PV) systems (with and without battery storage). A hybrid methodology is proposed, combining and comparing two approaches to studying building performance under uncertainty: (i) physics-based building performance simulations coupled with parametric variations of occupant behavioral profiles (e.g., austere vs. wasteful), and (ii) data-driven modeling using a large national building dataset. The approach is illustrated and validated on small, medium, and large-sized office buildings in different climate zones (hot dry, mixed marine, and cold humid). Results show that different building operational patterns could lead up to 60% increase in building electric demand, which translated to similar increases in PV energy capacity and the corresponding capital costs of the systems. The findings emphasize the urgent need to better account for uncertainty in building operational patterns in the design workflows of buildings with PV generation and energy storage capabilities.

Effects of changing criteria on improving interRAI assessment for elder abuse: analysis of a national dataset from Aotearoa New Zealand

ObjectivesGlobally, one in six older adults in the community will be a victim of abuse (elder abuse; EA). Despite these horrific statistics, EA remains largely undetected and under-reported. Available screening...

Trends in incidence of pneumothorax in England before, during and after the COVID-19 pandemic (2017–2023): a population-based observational study

COVID-19 is a risk factor for pneumothorax. The pandemic may have influenced healthcare-seeking behaviour for pneumothorax. This study aimed to investigate recent trends in the incidence of pneumothorax in England. A population-based epidemiological study was conducted using an English national dataset of hospital admissions (Hospital Episode Statistics) from 2017 to 2023. Record-linkage was used to identify multiple admissions per person and co-morbidity. Pneumothoraces co-occurring with COVID-19 were identified by concurrent COVID-19 diagnostic coding. The pre-pandemic (January 2017-February 2020), pandemic (March-2020-February-2021) and post-pandemic periods (March 2021-March 2023) were compared. From 2017 to 2023, there were 72,275 hospital admissions for spontaneous pneumothorax among 59,130 patients. Admissions showed marked variability, peaking in January 2021 when the rate of admissions was about two-thirds higher than that of the pre-pandemic level (Incidence rate ratio [IRR] 1.65, 95% CI: 1.48-1.84). However, when excluding patients with a concurrent COVID-19 diagnosis, the overall trend shifted to a reduction during the pandemic period. Post-pandemic rates were not significantly different from pre-pandemic levels (IRR=0.96, 95% CI: 0.89-1.04). The incidence of spontaneous pneumothorax was significantly higher in males (rate ratio compared to females: 2.29, 95% CI: 2.19-2.39). However, the trends were consistent in both males and females. This study highlights a significant peak in COVID-19 related cases but a corresponding trough in non-COVID-related cases (end 2020, early 2021). Despite a previous report of increasing incidence of (non-COVID-related) hospitalised spontaneous pneumothorax over the long-term between 1968 and 2016, we did not observe any continued increase throughout this study period, prompting further investigation into the impact of recent guidelines. Authors are supported by the NIHR Oxford BRC, Li Ka Shing and Robertson Foundations, MRC, and HDR UK.

Can Nationwide Central Appointment Systems Reduce Waiting Times in Turkish Public Hospitals?

Health service delivery is an important component of a well-functioning health system. To achieve a competitive healthcare system, healthcare should be provided on time to avoid delays that could harm the patient. In this respect, patient wait time is an important indicator of health services delivery performance. Countries develop national or regional booking systems to manage patient wait times and healthcare delivery resources more efficiently. In this study; the effect of a national booking system on outpatient wait times in Turkish public healthcare settings was investigated. This study was conducted using anonymized national outpatient data sets for the year 2016 with permission from the Republic of Turkey Ministry of Health. The data was analyzed after pre-processing and transformation. As a result of the study, patient wait times were calculated, analyzed and evaluated according to province and facility care levels (secondary or tertiary). Results showed that in 2016, only 30.69% of outpatient visits had appointments and that the average waiting time for patients with appointments was 11.18% shorter than for patients without appointments. The results of this study fill a gap in the literature as almost no studies have investigated this issue due to a lack of administrative and clinical data and will provide important evidence for the improvement of health service delivery systems.

Variability in treatment effects in an English national dataset of psychological therapies: The relationships between severity, treatment duration, and therapy type

BackgroundComparisons between bona fide psychological therapies generally report no effects or small effects favoring cognitive behavioral therapy (CBT), suggesting that differences between therapy modalities are of little importance. MethodsAn observational, cohort study of patients (N = 11,116), drawn from the English Talking Therapies program. Patients presented with depression and were treated by CBT or person-centered experiential therapy (PCET), 67 % were female and the age range was 15–94. Multilevel modeling was used to identify variables associated with outcomes and CBT and PCET outcomes were compared dependent on the number of sessions patients attended and the severity of their depression at intake. ResultsAlthough overall a small effect size of 0.14 (0.10, 0.18) favored CBT, we found differing effect sizes depending on patient severity and the number of sessions they had attended at outcome. For non-clinical and moderately depressed patients no significant differences between therapies were found. For moderately-severe and severe patients there was a crossover in effectiveness with PCET more effective up to 5 or 6 sessions and CBT more effective thereafter. However, small effects in favour of PCET were unreliable. The largest effects were found for CBT for patients who were moderately-severe and had >10 sessions (d = 0.30, 0.12, 0.48) or were severe and had >12 sessions (d = 0.26 (0.02, 0.49). LimitationsNo data was available on therapy allocation decisions or therapists and the results may not be generalizable to non-NHS Talking Therapies services. ConclusionsSmall effects can mask important contextual differences between therapies and their study can inform allocation decisions.

Breast cancer trends in Chile: Incidence and mortality rates (2007–2018)

Breast cancer (BC) is one of the most common cancers in women worldwide and in Chile. Due to the lack of a Chilean national cancer registry, there is partial information on the status of BC in the country. We aim to estimate BC incidence and mortality rates by health care providers and regions for Chilean women. We used two public anonymized databases provided by the Ministry of Health: the national death and hospital discharges datasets. We considered a cohort of 58,254 and 16,615 BC hospital discharges and deaths for the period 2007–2018. New BC cases increased by 43.6%, from 3,785 in 2007 to 5,435 in 2018. Total BC deaths increased by 33.6% from 1,158 to 1,547 during the same period. Age-adjusted incidence rates were stable over time, with an average rate of 44.0 cases/100,000 women (SD 2.2). There were considerable differences in age-adjusted incidence rates among regions, with no clear geographical trend. Women affiliated to a private provider (ISAPRE) have an average age-adjusted incidence rate of 60.6 compared to 38.8 (both cases/100,000 women) for women affiliated with the public provider (FONASA). Age-adjusted mortality rates have an average of 10.5 cases/100,000 women (SD 0.4). This study shows important differences in incidence rates between private and publicly insured women, with no significant differences in mortality rates. Such differences may be associated with women’s lifestyles, dietary compositions, comorbidities, and differences in healthcare systems. These hypotheses should be studied in greater depth. Additionally, differences in BC incidence found in this study compared to incidences reported from other estimations reinforce the need of a national cancer registry that should lead to more accurate indicators regarding BC in Chile.

Sensitivity for thee, but not for me: The role of social status as a conduit for white-collar prison adjustment

The special sensitivity hypothesis asserts that the atypical background and personal characteristics of white-collar offenders may make them particularly susceptible to the “pains of imprisonment” while incarcerated. Using a national data set of U.S. prisoners, we evaluated symptoms of negative affect, misconduct, and various institutional outcomes among two distinct groups of white-collar offenders: those defined by their crime of exploiting specialized access for profit and those further defined by their status (i.e., employment, finances, and education). Findings indicated that the status-based offenders reported feeling significantly less worthless and that they were significantly more likely to have held a work assignment. However, the offense-based group was significantly less likely to have participated in educational programming and exhibited significantly worse negative affect—specifically nervousness, restlessness, and depression—suggesting they had greater difficulty adapting to prison life compared to others. We conclude by examining the implications for criminological theory and criminal justice policy.

Australian vaccine preventable disease epidemiological review series: Hepatitis B, 2000-2019.

Hepatitis B vaccination was nationally funded for adolescents in 1996, with inclusion of universal infant immunisation under the National Immunisation Program (NIP) in May 2000. This study describes hepatitis B epidemiology in Australia in the two decades since 2000. This article analyses newly-acquired (within the prior 24 months) and unspecified (all other) hepatitis B notifications (2000-2019) from the National Notifiable Diseases Surveillance System; acute hepatitis B hospitalisations (2001-2019) from the National Hospital Morbidity Database; and acute (2000-2019) and chronic (2006-2019) hepatitis B deaths from the Australian Bureau of Statistics and Australian Coordinating Registry. Rates over the reporting period were described overall, and by age group, sex, and Aboriginal and Torres Strait Islander status (Aboriginal and/or Torres Strait Islander versus other [neither Aboriginal nor Torres Strait Islander, unknown or not stated]). Trend analyses were performed using Poisson or negative binomial regression. Additional analyses were performed for the cohort born after May 2000. The annual all-age notification rate per 100,000 per year declined (p < 0.001) from 2.13 in 2000 to 0.65 in 2019 for newly-acquired hepatitis B and from 38.3 to 22.3 for unspecified hepatitis B (likely to predominantly represent chronic hepatitis B). Newly-acquired and unspecified hepatitis B notification rates were lowest among children aged < 15 years. The most substantial reductions in notification rates of newly-acquired hepatitis B were among adolescents aged 15-19 years and young adults aged 20-24 and 25-29 years (respectively 17-, 11-, and 7-fold); these age groups also recorded the most substantial reductions in unspecified hepatitis B notifications (respectively 5-, 3.5-, and 2-fold). Newly-acquired hepatitis B notification and acute hepatitis B mortality rates were two- to threefold higher in males than females. The all-age newly-acquired hepatitis B notification rate in Aboriginal and Torres Strait Islander people decreased twofold between 2000 and 2019, but remained threefold higher than in other people. Acute hepatitis B hospitalisations also declined over the study period (p < 0.001) and followed similar patterns. There were no acute or chronic hepatitis B deaths among people born after May 2000; this cohort featured 52 newly-acquired and 887 unspecified hepatitis B notifications. Due to lack of data on country of birth (and hence eligibility for infant vaccination under the NIP or overseas programs), vaccination status and likely transmission routes, we were unable to assess factors contributing to these potentially preventable infections. Adolescent and infant immunisation under the NIP has led to significant reductions in notification rates of newly-acquired hepatitis B, and in acute hepatitis B hospitalisation rates, both overall and in Aboriginal and Torres Strait Islander people. Unspecified hepatitis B notification rates have also greatly decreased in children and young adults, likely largely due to the impact of overseas infant immunisation programs on prevalence in child and adolescent migrants. Work to improve completeness of variables within national datasets is crucial, along with enhanced surveillance of both newly-acquired and unspecified hepatitis B cases to investigate transmission routes, vaccination status and factors contributing to acquisition of hepatitis B, in order to optimise the impact of immunisation programs and ensure linkage with care.

Fast, accurate and accessible calculations of leaf temperature and its physiological consequences with NicheMapR

Abstract Mechanistic predictions of ecological niches are fundamentally based on energy and mass exchange processes that, to be realistic, must be linked to microclimate and incorporate behaviour and physiology. Estimates of leaf temperature and associated transpiration and net photosynthesis rates are fundamental in ecology, agriculture and global change biology. Equations for calculating leaf energy budgets have been available for over 60 years and complex models of stomatal behaviour have been developed. However, user‐friendly ways of estimating leaf temperature under realistic microclimatic regimes, including soil moisture effects, remain limited. Here we show that the integrated microclimate and ectotherm functions of the NicheMapR package for the R programming environment can be used to make fast and effective estimates of leaf temperature and associated rates of water loss and photosynthesis for a wide range of leaf functional types, root depths and microhabitats. Stomatal conductance may be constant or simulated to change dynamically (a) as a function of vapour pressure deficit and CO2 concentration, (b) as a function of soil water potential and (c) as a thermoregulatory mechanism to avoid heat stress. We tested the approach against hourly leaf temperature observations in summer from an arid shrubland in Australia, a temperate woodland in Montana USA, along an elevational gradient in Colorado USA, and at a botanical garden in Florida, USA. National or global gridded data sets can provide the required forcing data but local observational data or some combination of local and gridded data can be used. The global ERA5 and NCEP datasets allow historical leaf energy budget calculations to be made anywhere in the world and a Shiny app has been developed to facilitate use of the model with these datasets. Situated leaf energy budget calculations can be used to design informative field programs to collect much needed detailed temporal data on leaf temperature under natural settings, enabling better predictions and interpretations of how plants respond to environmental change.

Impact of China's carbon emissions trading scheme on firm-level pollution abatement and employment: Evidence from a national panel dataset

As an emerging economy, China has implemented market-oriented carbon emissions trading schemes in response to growing environmental challenges. Yet, concerns persist regarding the potential hindrance of these policies on socio-economic progress due to increased costs and possible declines in employment rates. Using a novel rich panel dataset of small-medium enterprises from 2011 to 2015, this study employs time-varying difference-in-differences methods to provide robust empirical evidence on the effect of these carbon trading policies. The findings reveal that the trial programs notably decreased sulfur dioxide emissions at the firm level by 2–3%, concurrently fostering a 6–7% increase in employment, indicating the realization of a ‘double dividend.’ An analysis of variations demonstrates that non-state enterprises, foreign-owned companies, and industries with substantial pollution levels experienced the most significant benefits, particularly with heightened positive impacts on employment observed in Western regions. Upon delving into the mechanisms involved, it becomes evident that initial job losses were offset by the emergence of new positions due to the expansion in output and the effects of substituting factors resulting from green investments catalyzed through the carbon trading initiative. These compelling findings strongly advocate for the widespread implementation of market-based tools on a national scale, providing robust support for concurrently addressing environmental concerns and promoting livelihood objectives within the specific context of China.

Indigenous representation and participation: The case of the Chilean Mapuche

According to the empowerment hypothesis, minority politicians encourage minority participation. The relationship between representation and participation has been extensively analyzed for several ethnic minorities and women, but there are no studies for indigenous populations in Latin America. This paper evaluates the link between descriptive representation and electoral registration of Mapuche, a deprived indigenous minority from the South of Chile that is as large as ten percent of the total population. We implement a panel estimation that controls district effects using a national dataset of more than three million new registrations in Chile for five municipal elections. We found that Mapuche mayors are significantly associated with higher Mapuche participation during the first year of the mayoral period. Since registration in Chile occurs throughout the representatives’ term, and we use registrations long before the next election, our evidence suggests that office-holding affects participation by channels other than electoral campaigning. To shed light on the channels, we describe the symbolic and substantive mechanisms used by Mapuche mayors to empower their communities.

Deep learning detection of diabetic retinopathy in Scotland’s diabetic eye screening programme

Background/AimsSupport vector machine-based automated grading (known as iGradingM) has been shown to be safe, cost-effective and robust in the diabetic retinopathy (DR) screening (DES) programme in Scotland. It triages screening...

(125) INTRAPARTUM AND 30-DAY POSTPARTUM COMPLICATIONS IN PREGNANCIES WITH ANTENATAL SARS-COV-2 INFECTION

Abstract Introduction While COVID-19 has been associated with adverse pregnancy outcomes, data regarding intrapartum and postpartum maternal complications after antenatal COVID-19 infection is limited and variable. Objective This study compares the intrapartum and postpartum complication rates between pregnant patients with and without an antenatal COVID-19 diagnosis in a national dataset. Methods This is a retrospective cohort study of patients who gave birth between January 2020 and May 2023 utilizing the TriNetx Analytics Research Network, an aggregated electronic health record platform. Our data searches were performed on May 1, 2023. ICD-10 codes were used to identify the encounter for delivery (ICD-10 code O80-O82) and pregnant individuals with a COVID-19 diagnosis (ICD-10 code U70.1) during their gestational period. The control group was defined as those with one encounter for delivery between January 2020 and May 2023 and without a diagnosis of COVID-19 during the gestational period. Complications included obstetric, cardiovascular, neurovascular, and pulmonary outcomes diagnosed from the day of delivery to 30 days postpartum. The cohort was propensity matched by age, race, and ethnicity. The relative risk values and 95% confidence intervals for the outcomes were calculated and compared. Results Of the 368,923 patients who had an encounter for delivery between January 2020 and May 2023, 26,974 (7%) had an antenatal COVID-19 diagnosis. Compared to our matched control cohort, patients with antenatal COVID-19 were at an increased risk of postpartum hemorrhage (RR 1.24, 95% CI 1.16-1.33), gestational hypertension without significant proteinuria (1.27 [1.21-1.34]), pre-eclampsia (1.25 [1.18-1.32]), eclampsia (1.66 [1.29-2.23]), and preterm labor (1.21 [1.12-1.31]). Patients with antenatal COVID-19 infections were also at an increased risk of postpartum complications, including cerebral infarction (1.74 [1.04-2.90]), pulmonary embolism (2.68 [1.74-4.13]), acute embolism and thrombosis of deep veins of lower extremity (2.32 [1.45-3.71]), sepsis (2.21 [1.54-3.19]), heart failure (1.55 [1.04-2.31]), and cardiomyopathy (2.08 [1.30-3.32]). There was no elevated risk of HELLP syndrome (1.18 [0.96-1.44]), placental abruption (1.14 [0.94-1.37]), and myocardial infarction (1.4 [0.62-3.15]). Conclusions Pregnant individuals with antenatal COVID-19 diagnosis were more likely to have intrapartum and postpartum encounter diagnoses for obstetric, cardiovascular, neurovascular, and pulmonary complications. This data allows providers to identify antenatal COVID-19 infection as a risk factor and monitor patients for complications. Disclosure No.

Multiple Imputation of Race and Hispanic Ethnicity in National Surveillance Data for Chlamydia, Gonorrhea, and Syphilis.

Disease burden of sexually transmitted infections such as chlamydia, gonorrhea, and syphilis is often compared across age categories, sex categories, and race and ethnicity categories. Missing data may prevent researchers from accurately characterizing health disparities between populations. This article describes the methods used to impute race and Hispanic ethnicity in a large national surveillance data set. All US cases of chlamydia, gonorrhea, and syphilis (excluding congenital syphilis) reported through the National Notifiable Diseases Surveillance System from the year 2019 were included in the analyses. We used fully conditional specification to impute missing race and Hispanic ethnicity data. After imputation, reported case rates were calculated, by disease, for each race and Hispanic ethnicity category using Vintage 2019 Population and Housing Unit Estimates from the US Census. We then used case counts from subsets that contained only complete race and Hispanic ethnicity information to investigate if the confidence intervals from the multiply imputed data included the observed number of cases in each race and Hispanic ethnicity category. Among the 2,553,038 cases reported in 2019, race and Hispanic ethnicity were multiply imputed for 9% of syphilis cases, 22% of gonorrhea cases, and 33% of chlamydia cases. In the subset analyses, every nonzero rate of reported cases was contained within the confidence intervals that were calculated from multiply imputed data. Confidence intervals that account for the uncertainty of the predictions are an advantage of multiple imputation over complete-case analysis because a realistic variance estimate allows for valid hypothesis testing results.

Conceptualising the correlates of adolescent suicidal behaviour in Benin: evidence from a national survey

BackgroundDespite efforts to increase awareness about suicide, related behaviours among adolescents in Benin persist as a significant health challenge globally. Nonetheless, there is a dearth of empirical evidence that conceptualises suicidal behaviour and its correlates to provide a better picture for preventive interventions. We analysed a national survey dataset of school-going Benin adolescents, with an analytical sample of 2,536.ResultsThe prevalence of suicidal ideation, plan, and attempt were 14.8%, 16.3%, and 15.3%, respectively. The likelihood of ideating suicide increased among adolescents who engaged in marijuana usage, encountered bullying, felt lonely, and experienced anxiety. Additionally, the likelihood of planning suicide was high among individuals who skipped school, used marijuana, encountered bullying, felt lonely, experienced anxiety, and engaged in multiple sexual relationships. Similarly, the likelihood of attempting suicide was increased among adolescents in grades 3-6 who skipped school, used marijuana, encountered bullying, and felt lonely. Nonetheless, being a male was protective against suicidal ideation and suicidal plans, while younger age was protective against suicidal attempts. Also, having parents who respected adolescents’ autonomy and privacy (never inspected their things without their knowledge) had lower odds of suicidal ideation.ConclusionSuicide prevention programmes must consider multidimensional protective and risk factors concerning adolescents’ personal, parental, family, and community settings in Benin.