Strengthening The Reporting Of Observational Studies In Epidemiology Guidelines Research Articles

A time-motion study on impact of spatial separation for empiric airborne precautions in emergency department length of stay.

To evaluate the impact of spatial separation on patient flow in the emergency department. This was a retrospective, time-and-motion analysis conducted from 15 to 22 August, 2022 at the emergency department of a tertiary hospital in Kuala Lumpur, Malaysia. During this duration, spatial separation was implemented in critical and semi-critical zones to separate patients with symptoms of respiratory infections into respiratory area, and patients without into non-respiratory area. This study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Patients triaged to critical and semi-critical zones were included in this study. Timestamps of patient processes in emergency department until patient departure were documented. The emergency department length-of-stay was longer in respiratory area compared to non-respiratory area; 527 min (381-698) versus 390 min (285-595) in critical zone and 477 min (312-739) versus 393 min (264-595) in semi-critical zone. In critical zone, time intervals of critical flow processes and compliance to hospital benchmarks were similar in both areas. More patients in respiratory area were managed within the arrival-to-contact ≤30 min benchmark and more patients in non-respiratory area had emergency department length-of-stay ≤8 h. The implementation of spatial separation in infection control should address decision-to-departure delays to minimise emergency department length of stay. The study evaluated the impact of spatial separation on patient flow in the emergency department. Emergency department length-of-stay was significantly prolonged in the respiratory area. Hospital administrators and policymakers can optimise infection control protocols measures in emergency departments, balancing infection control measures with efficient patient care delivery. STROBE guidelines. None. The study obtained ethics approval from the institution's Medical Ethics Committee (MREC ID NO: 20221113-11727). The author has checked and make sure our submission has conformed to the Journal's statistical guideline. There is a statistician on the author team (Noor Azhar).

Determination of the relationship between parents' health literacy and fever management of their children: Across-sectional study.

The research was conducted to determine the practices of parents regarding the fever management of their children and reveal the relationship between their health literacy (HL) and fever management of their children. Cross-sectional study was used. This study was carried out with 242 parents. The data were collected using the Parent Descriptive Information Form, Turkish HL Scale-32 and Parents' Fever Management Scale between September 2021 and September 2022. The data were evaluated with the SPSS program, using percentages, averages, Pearson's correlation and regression analysis. The mean age of the parents was 31.87 ± 6.59. The parents' mean Parents' Fever Management Scale score was 36.22. It means that parents had high fever management practice. Their mean Turkish HL Scale-32 total score was 34.43. 51.6% of the parents had a problematic or insufficient HL level. In the cases of fever, 61.2% of the parents stated that they took off the child's clothes, 69.0% measured temperature from the armpit, and 55.4% gave antipyretics according to the doctor's prescription. There is a statistically significant positive correlation between the Parents' Fever Management Scale and Turkish HL Scale-32. It is observed that 8.2% of the change in parents' fever management is explained by HL. The study found that with an increase in parents' HL, fever management of their children also increased. Emerging evidence showed that developing parents' HL knowledge and skills could be an option/approach in fever management. It should be a basic nursing skill that to provide HL support to parents. This study adhered to the relevant cross-sectional STROBE (the Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. No patient or public contribution.

Evaluation of school-based interventions including homework to promote healthy lifestyles: a systematic review with meta-analysis

Abstract Aim It is important to promote healthy lifestyles in youth through initiatives in school, which is a preferred setting to implement health-related interventions also targeted at families to be more effective. This study aimed to synthesise school-based interventions including homework and extracurricular activities for the promotion of healthy lifestyles, especially healthy nutrition and physical activity, in children and adolescents. Methods This systematic review was conducted according to the PRISMA guidelines. Quality assessment was performed using the Cochrane Tool for Quality Assessment for randomized and non-randomized control trials, while the STROBE (Strengthening the Reporting of Observational studies in Epidemiology) guidelines were used for observational studies. Results From the 1356 studies identified, eight were included. Across studies, a significant effect was found in increasing fruit and vegetable consumption and reducing snack and sugar intake, while no effect was found for moderate to vigorous physical activity (MVPA) unless for light PA (LPA) and step counts. The results of BMI and waist circumference are still unclear after performing a meta-analysis of three studies. Conclusion School-based interventions including homework and extracurricular activities were shown to improve nutritional behaviour, step counts, and LPA. Despite some statistically significant results, the effects of BMI and waist circumference are still unclear. Further studies are needed to demonstrate that these intervention s can represent an effective strategy for obesity prevention.

Quality of Life in Psoriasis: A Cross-Sectional Study from North India.

Psoriasis is a chronic inflammatory papulo-squamous disease characterized by multiple remissions and relapses. This study aimed to assess the impact of psoriasis on the quality of life of patients. A hospital-based, cross-sectional study was conducted enrolling 198 adult patients of psoriasis. The STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines for observational studies were followed. Clinical severity of psoriasis was measured using Psoriasis Area Severity Index (PASI), and quality of life was measured by EuroQoL 5D (EQ-5D-5L, EQ-VAS) and Psoriasis Quality-Of-Life-12 (PQOL-12) Questionniares. Of the 198 patients, 71.7% (n = 142/198) were males with a mean age of 41.65 ± 13.19 years. The mean PASI score was 12.46 ± 11.51, and the mean PQOL-12 score was 50.18 ± 23.36. Up to 22.7% (n = 45) cases had 'severe' and 6.1% (n = 12) cases has 'very severe' PQOL-12 scores. Statistically significant correlation (P < 0.05) was observed between PASI scores and almost all domains of EQ-5D-5L and PQOL-12. Psoriasis affects most psycho-social domains of a patient's life. Coping with these QOL issues remains a challenge to the patients in everyday life. The goal of management of psoriasis therefore must include measures to improve quality of life along with long-lasting remittance of physical symptoms.

Effects of a Gait Training Program on Spinal Cord Injury Patients: A Single-Group Prospective Cohort Study

Introduction: Spinal cord injury is defined as the pathological process produced by any etiology affecting the spinal cord, which may alter motor, sensory, and/or autonomic function below the level of the lesion. The complexity of the neurological deficit and, therefore, the resulting clinical picture depends on the level of the lesion, the extent, and the affectation of the white or gray substance. This injury can totally or partially affect the ability to walk, and its highest priority with respect to mobility is to restore the ability to walk. All of which make the improvement of the methods used in their rehabilitation a top priority for health systems. Objective: The main objective of this study was to evaluate the effect of a gait training program for patients with spinal cord injuries. Material and Methods: A single-group, prospective cohort study was developed following the Strengthening the Reporting of Observational Studies in Epidemiology Guidelines (STROBE) at the International Center for Neurological Restoration of Siboney Playa (Havana, Cuba) from May 2020 to July 2021 with a sample of 30 patients by accidental or deliberate non-probabilistic sampling that met the expected inclusion criteria, who underwent a physical rehabilitation program for 8 weeks of work. Results: Statistically significant changes were observed in the overall course, by sex, by topographic level of lesion, and by functional class. Conclusions: The gait training program used produced significant changes in thoracic spinal cord injured patients regardless of the level of injury, sex, or functional class of the patient.

The risk and prevalence of pressure injuries in older people in the home care service: a cross-sectional study.

This study aimed to understand the risk of developing pressure injuries (PIs) and their prevalence rate in older adults in Italy who received public funded home care services and who were often living alone. In May 2019, a cross-sectional study was performed according to the STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) guidelines. The data collection included demographic variables, a PI risk assessment using the Braden Scale score, the type of mobility devices available, the wound description detailing the PI category, body location and ongoing treatment. Data analysis was conducted using non-parametric descriptive statistics. Of the 2223 patients who participated in the study, the risk of developing a PI as measured with the Braden Scale sore was: 'absent' for 37.7%; 'mild' for 25.8%; 'moderate' for 13.8%; 'high' for 15.5%; and 'severe' for 7.1% of patients. The PI prevalence in the sample of home care service patients was 26%, of which 46% were inpatients with a Braden Scale score of <14. Of the PIs that developed during the study, 65% of these developed in patients in home care and of these, 81% had a Braden Scale score of ≤9. PIs developed not only during hospitalisation but at home. Assessing the commitment of patients and caregivers to PI prevention and treatment strategies in home care services could be key to reducing PI prevalence, hospital admissions for PIs, related complications for older people living at home, and the severity of the PI category.

Comparative evaluation of the effects of lighting conditions on the shade selection of maxillary central incisor using visual methods

Background: The selection of shade of a tooth is a routine practice for a dentist, especially a prosthodontist, to make esthetically pleasing prostheses. The phenomenon of colour is a matter of perception by the eye. Every opaque object receives light, absorbs some of it and reflects the rest. A tooth being an opaque object, reflects some amount of light. The dominant wavelength of this reflected light is discerned by us as the colour of the tooth. Light has variable properties that influence our perception. Daylight is regarded as the standard source for the selection of the colour of a tooth. Conversely, the lack of optimal circumstances during different times of the day necessitates using artificial illuminants to select shade of a tooth. This study was carried out to compare the accuracy of a shade-matching light (SMILE LINE) to that of standard daylight. Methods: This study followed the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines for cross-sectional studies. The study comprised 125 participants of ages ranging from 20 to 30 years. Five observers from the Department of Prosthodontics, Sharad Pawar Dental College (SPDC), Wardha selected the shade of the maxillary central incisor of 125 subjects under sunlight, dental operatory light, and shade-matching light. The statistical analysis was performed using the SPSS software, and Kappa statistics were used to compare the shades selected by the shade-matching light and dental operatory light with sunlight. Results: A strong correlation was discovered between the shades of tooth selected under the shade matching light and shades selected under sunlight for four out of five observers. Conclusions: The shade correcting device gives shades comparable to those selected under sunlight in ideal conditions making it useful as an alternative to sunlight for shade selection.

Bronchoalveolar lavage hemosiderosis in lightly active or sedentary horses.

Hemosiderophages in bronchoalveolar lavage fluid (BALF) are commonly ascribed to exercise-induced pulmonary hemorrhage (EIPH). Little information exists regarding the presence of these cells in horses that perform light or no work and that are referred for respiratory problems. Evaluate the presence of hemosiderophages in BALF of horses suspected of respiratory disease without history of or risk factors for EIPH and determine predictors of hemosiderophages in BALF in this population. Observational retrospective cross-sectional study using STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. Bronchoalveolar lavage fluid cytology reports of 353 horses evaluated for respiratory disease between 2012 and 2022 at the Cummings School for Veterinary Medicine were reviewed retrospectively. Horses with a history or likelihood of having performed past strenuous exercise were removed, and the remaining 91 horses were divided into hemosiderin-positive (HSD-POS) and hemosiderin-negative groups based on Perls' Prussian blue staining. Potential predictors for the presence of hemosiderophages in BALF (history, clinical evaluation, baseline lung function, airway reactivity, BALF cytology, and hemosiderin score) were compared between the 2 groups, using univariate and multivariate analyses. Horses with a diagnosis of severe equine asthma (sEA; odds ratio, 11.1; 95% confidence interval, 3.2-38.5; P< .001) were significantly more likely to be HSD-POS than horses with mild-to-moderate equine asthma. Hemosiderophages were found in the BALF cytology in a subset of horses that perform light or no work and presented for respiratory signs; these cells were found more frequently in horses with sEA. The link between hemosiderophages and sEA highlights previously unstudied pathology associated with this common disease.

Poor reporting quality of observational studies in children with non-syndromic cleft palate makes evidence synthesis difficult

Objective To assess the reporting quality of observational studies included in a systematic review of the management of chronic otitis media with effusion in children with non-syndromic cleft lip and palate using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. Methods Medline, CINAHL, Scopus and Embase, were searched for studies comparing the use of ventilation tubes to surveillance. Two reviewers screened potential eligible articles, extracted data independently and assessed reporting quality using the STROBE checklist. Results The median compliance rate with individual STROBE items was low at 25% (range:0-100%) with 11 of the 22 items not reported in any of the studies. Items reported inconsistently pertained to potential sources of bias, sample size calculations, how loss to follow-up was addressed and management of missing data. Conclusion The development of this systematic review highlights the inadequate reporting standards in this field. Differences in the way the outcomes are defined, reported, and measured leads to variability in the observed intervention effects and difficulty in interpreting the true effect size. Future researchers are encouraged to use STROBE guidelines for the design and reporting of observational studies in this field.

Selective serotonin reuptake inhibitors as a risk factor for dental implant failure: a retrospective clinical study

The trend in recent decades in Europe and the United States points to an exponential increase in the consumption of antidepressant drugs and, in particular, selective serotonin reuptake inhibitors (SSRIs). This retrospective study aimed to investigate whether there is an association between SSRI intake and dental implant (DI) failure or survival and, secondarily, to investigate the influence of other systemic and local factors. This retrospective cohort study was done in accordance with the the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines for observational studies. A total of 170 patients received 573 DIs between 2014 and 2020.The reported DI failure rate was 6.11% (n = 35 DIs). Of these 18.31% failed in patients treated with SSRIs while 4.38% failed in patients who were not prescribed SSRIs (p < 0.001). Specifically, use of these drugs was associated with a hazard ratio rate of DI failure that was 4.53 times higher (95% CI: 1.93 to 10.61), and in the multivariate analysis, a 3.70 times higher adjusted risk was found. A lower DI survival rate at 90 months’ follow up was also observed in these patients compared with those not taking them (84.30% vs 96%, respectively; p = 0.00014). With the limitations of the present study it can be affirmed that there is a relation between the intake of SSRIs and DI failure, as well as a lower survival rate in these patients.

High fitness levels attenuate the increased risk of heart failure due to low socioeconomic status: A cohort study

High fitness levels attenuate the increased risk of heart failure due to low socioeconomic status: A cohort study

Gender differences among professionals dedicated to Oral Implantology in Spain: An observational study.

BackgroundDespite the development of society and the educational progress achieved at the university education level, women continue to face obstacles that hinder their professional development. This study aims to determine whether there are gender differences in a representative sample of professionals dedicated to Oral Implantology in Spain. Material and MethodsThis is a cross-sectional observational study based on the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. An electronic survey consisting of two blocks of questions was sent to members of the Spanish Society of Implants. The data were analyzed using descriptive analysis. ResultsA total of 303 participants (20.8%) responded to the questionnaire, of which 219 were men (72.3%) and 84 women (27.7%). Up to the age of 40 years, women predominate, whereas men predominate from the age of 51 years onwards, which is influenced by a greater number of years of experience in implant placement and a higher number of implants placed per year. Despite this, women have a higher level of training in Oral Implantology, as a greater proportion are trained through master’s degrees. ConclusionsThe greater representation of men in the study is associated with the ageing of the sample. The results obtained from the present study anticipate the trend of a greater presence of the female gender in Oral Implantology in Spain in the coming years. Key words:Sex differences, dentistry, oral implantology, feminism, gender.

Psychological Resilience, Metacognitions, and Fear of Recurrence Among Cancer Survivors and Family Caregivers.

Cancer is a life crisis that can have devastating consequences not only on the affected individual but also on his/her caregivers. The aim of this study was to investigate the influence of psychological resilience and metacognitions of cancer survivors and their family caregivers (FCs) on fear of recurrence (FoR). This study used a cross-sectional design while adhering to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. Data were collected from 112 cancer survivors and 112 FCs recruited from 5 oncology hospitals. The cancer survivors and caregivers reported low levels of psychological resilience, which we found to be correlated with great fear of recurrence in cancer survivors and FCs. It was also in relation with metacognitions in cancer survivors and FCs.The findings showed that psychological resilience negatively predicted the fear of recurrence, whereas the metacognitions positively predicted the fear of recurrence in cancer survivors and FCs. The total effects of psychological resilience on the FoR in cancer survivors and FCs were 0.920 (confidence interval [CI], -2.059 to 0.072) and 0.061 (CI, -0.475 to 0.474), respectively. The total effects of metacognition on the FoR in cancer survivors and FCs were 1.164 (CI, 0.217-2.371) and 0.486 (CI, 0.016-1.058), respectively. The findings underline the direct and indirect mediating role of psychological resilience and metacognition of cancer survivors and FCs on FoR. The findings are particularly important to oncology nurses, who as 24-hour care providers are important sources of psychosocial care. Their awareness of factors influencing FoR is critical for achieving positive outcomes.

Preventive Antibiotic Prescribing Habits among Professionals Dedicated to Oral Implantology: An Observational Study.

The prescription of preventive antibiotics (PA) in oral implantology is a controversial issue. The study aimed to determine the prescribing habits of PA in professionals dedicated to oral implantology in various treatments in healthy and at-risk patients. This is a cross-sectional observational study based on the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. An electronic survey consisting of 4 blocks of questions was sent to members of the Spanish Society of Implants. The data were analyzed using descriptive analysis. A total of 303 participants (20.8%) responded to the questionnaire. One percent never prescribed PA, 55.4% prescribed them always, and 43.6% prescribed them sometimes. Ninety-six percent administered them preoperatively, while 92.4% administered them postoperatively. The most commonly used antibiotic is amoxicillin followed by amoxicillin with clavulanic acid (875/125 mg). Clindamycin is the most commonly administered antibiotic in patients with allergies. Professionals dedicated to oral implantology frequently prescribe PA in both healthy and at-risk patients, especially perioperatively. Immediate implant placement, sinus lifts, bone regeneration, and multiple implant placement are the treatments in which PA are most commonly prescribed, as well as in patients with heart valve prostheses or a history of bacterial endocarditis and immunodeficiency.

Alveolar bone heights of maxillary central incisors in unilateral cleft lip and palate patients using cone-beam computed tomography evaluation.

PurposeThe aims of this retrospective cross-sectional study were to measure and compare labial and palatal alveolar bone heights of maxillary central incisors in unilateral cleft lip and palate patients, following STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines.Patients and methodsThe study group consisted of 21 patients with a mean age of 16 years. High-resolution cone-beam computed tomography was performed at least one year after secondary alveolar bone grafting. The experimental side was the cleft side and the contralateral side without congenital cleft was the control. Measurements were performed on incisors’ midsagittal cross-sections. The Wilcoxon signed-rank test was used for intergroup comparisons.ResultsThe labial and palatal distances between alveolar bone crests and cementoenamel junctions were significantly greater on the cleft side than on the noncleft side. Mean differences were 0.75 and 1.41 mm, respectively. The prevalence of dehiscences at the cleft side maxillary central incisors was 52% on the labial surface and 43% on the palatal surface. In the controls, it was 19% and 14%, respectively.ConclusionThe cleft-adjacent maxillary central incisors had more apically displaced alveolar bone crests on the labial and palatal sides of the roots than the controls. Higher prevalence of dehiscences was found on the cleft side. Bone margin differences predispose to gingival height differences of the central incisors. These differences could increase the demands of patients to obtain more esthetic treatment results with orthodontic extrusion and periodontal intervention on the cleft side.Supplementary InformationThe online version of this article (10.1007/s00056-020-00276-w) contains supplementary information, which is available to authorized users.

An update on Heck's disease-a systematic review.

Previous research has suggested an ethnic association of Heck's disease with a prominent genetic and familial inheritance pattern, but no systematic review has been reported, which has collected all the evidence in one paper. The aim was estimation of the updated age estimates and gender predilection of this disease and also questioning its proposed link to ethnic and geographical factors. Heck's disease from 1966 until present are tabulated, including various descriptive characteristics. After removal of duplicates and adhering to all the inclusion criteria, we shortlisted 95 case reports. The quality assessment of all included studies has been done following STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) guidelines. We found an age range of 3-92years (mean: 23.1years) with a male to female ratio of 3:4. Geographical distribution revealed one of the main findings of this study, which was an increased incidence of Heck's disease in the European region. As already observed and established, there is a much greater prevalence of this disease in the indigenous populations of the world and more research should be encouraged to understand the correct transmission and pattern of spread of this disease.

Critically Ill Adults With Coronavirus Disease 2019 in New Orleans and Care With an Evidence-Based Protocol

BackgroundCharacteristics of critically ill adults with coronavirus disease 2019 (COVID-19) in an academic safety net hospital and the effect of evidence-based practices in these patients are unknown.Research QuestionWhat are the outcomes of critically ill adults with COVID-19 admitted to a network of hospitals in New Orleans, Louisiana, and what is an evidence-based protocol for care associated with improved outcomes?Study Design and MethodsIn this multi-center, retrospective, observational cohort study of ICUs in four hospitals in New Orleans, Louisiana, we collected data on adults admitted to an ICU and tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) between March 9, 2020 and April 14, 2020. The exposure of interest was admission to an ICU that implemented an evidence-based protocol for COVID-19 care. The primary outcome was ventilator-free days.ResultsThe initial 147 patients admitted to any ICU and tested positive for SARS-CoV-2 constituted the cohort for this study. In the entire network, exposure to an evidence-based protocol was associated with more ventilator-free days (25 days; 0-28) compared with non-protocolized ICUs (0 days; 0-23, P = .005), including in adjusted analyses (P = .02). Twenty patients (37%) admitted to protocolized ICUs died compared with 51 (56%; P = .02) in non-protocolized ICUs. Among 82 patients admitted to the academic safety net hospital’s ICUs, the median number of ventilator-free days was 22 (interquartile range, 0-27) and mortality rate was 39%.InterpretationCare of critically ill COVID-19 patients with an evidence-based protocol is associated with increased time alive and free of invasive mechanical ventilation. In-hospital survival occurred in most critically ill adults with COVID-19 admitted to an academic safety net hospital’s ICUs despite a high rate of comorbidities.

Are School Oral Health Programs Effective in Changing Dental Health and Health Behavior of Children; an Observational Study

BACKGROUND: Oral health issues are recorded to be growing among children due to either insufficient knowledge or ineffective oral health care. The study investigated the effectiveness of the school oral health (OH) program for changing dental health and health behavior among the students in Saudi Arabia. &#x0D; &#x0D; METHODS: This cross-sectional design study followed STROBE (strengthening the reporting of observational studies in epidemiology) guidelines to include 348 female primary children in Madinah, Saudi Arabia. These were equally divided into three groups; i.e., teacher delivered oral health program, dentist delivered oral health program, and lastly control group. Data was collected through a close-ended questionnaire, and were analyzed through descriptive statistics and ANOVA. &#x0D; &#x0D; RESULTS: Findings of the study showed improved OH status, better OH knowledge, behavior and practices among children. Self-evaluation results showed that the teachers conducted education program was more effective, then the dentists conducted education program. Also, oral health-related quality of life (OHRQoL) score was found high for the psychological aspect of the children. &#x0D; &#x0D; CONCLUSION: The effectiveness of the school oral health program for changing dental health and health behavior among the students was better.

Trends in Depressive Symptoms and Suicidality: Youth Risk Behavior Survey 2009-2017.

Death by suicide is the second leading cause of death among adolescents globally. Healthy People 2020 set a goal to reduce by 10% the rate of suicide attempts that required treatment and designated the Youth Risk Behavior Survey (YRBS) to measure this objective. This study used cross-sectional YRBS data (2009-2017) to (a) investigate whether gender moderates the linear time trend for the rate of depressive symptoms, suicidal ideation, and suicide attempts among high school students within the United States; (b) estimate these same measures stratified by gender; and (c) investigate whether the Healthy People 2020 goal for reduction in suicide attempts was met in 2017 for males and females. Secondary analysis of nationally representative high school students using YRBS data 2009-2017 were analyzed using R and the R survey package. Based on Strengthening the Reporting of Observational Studies in Epidemiology guidelines (STROBE), additive interactions using rate difference were compared to multiplicative interactions using odds ratios. Additive interactions were identified between female gender and linear trends for depressive symptoms, suicidal ideation, and suicide attempts requiring treatment. Females, but not males, had positive linear trends for depressive symptoms, suicidal ideation, and suicide attempts requiring treatment. Suicide attempts requiring treatment among females was 36% higher in 2017 than in 2009 but decreased 13% in males during the same period. The Healthy People 2020 goal to reduce suicide attempts requiring treatment by 10% has not been met among females. The divergent trends by gender highlight the importance of surveillance measures by gender. Future research is needed to identify better suicide prevention strategies that address underlying factors and are gender specific.

Childrearing Practices Among Sub-Saharan African Migrants in Australia: a Systematic Review

Australian Child Protection practitioners who work with children from sub-Saharan African migrant backgrounds often face challenges when applying child protection laws and policies to address childrearing and parenting issues. The aim of this study is to examine the influence of cultural beliefs, values, attitudes and practices on childrearing practices within sub-Saharan African communities. The systematic review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Databases searched included Science Direct, ProQuest Central, Embase, EbescoHOST (Medline; PsychINFO; CINAHL; ERIC; SocINDEX; PsycARTICLES), Web of Science (SCI-EXPANDED; SSCI) and Google Scholar; the search dates were from January 2000 to December 2016. The studies were assessed using the Consolidated Criteria for Reporting Qualitative Research (COREQ) and the Strengthening the Reporting of Observational studies in Epidemiology guidelines (STROBE). The search strategy identified 2631 articles, of which 57 met the inclusion criteria for the review. Participants were children aged from three months old to seventeen years and adults aged eighteen years or older. Data analysis resulted in 7 primary themes: Illness Conception, Traditional Beliefs and Health-seeking Behaviour; Fosterage and Community Responsibility; Family Dynamics; Discipline; Child Spirits and the Supernatural; Body Stimulation; and Female Genital Mutilation. Framed within the acculturation theory, the review identifies important factors that converge to provide insight into the specific caregiving context of sub-Saharan African families. It further makes clear that, for the most part, the childrearing practices of sub-Saharan African migrants who settle in Australia are influenced by their cultural values and norms.