20 results
Salmonella Saintpaul outbreak associated with cantaloupe consumption, the United Kingdom and Portugal, September to November 2023
- Luke J. McGeoch, Ann Hoban, Clare Sawyer, Hussein Rabie, Incident Team, Anaïs Painset, Lynda Browning, Derek Brown, Caitlin McCarthy, Andrew Nelson, Ana Firme, Ângela Pista, Joana Moreno, João Vieira Martins, Leonor Silveira, Jorge Machado, Paula Vasconcelos, Oluwakemi Olufon, Carmellie Inzoungou-Massanga, Amy Douglas, Jacquelyn McCormick, Lesley Larkin, Sooria Balasegaram
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- Journal:
- Epidemiology & Infection / Volume 152 / 2024
- Published online by Cambridge University Press:
- 06 May 2024, e78
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In September 2023, the UK Health Security Agency identified cases of Salmonella Saintpaul distributed across England, Scotland, and Wales, all with very low genetic diversity. Additional cases were identified in Portugal following an alert raised by the United Kingdom. Ninety-eight cases with a similar genetic sequence were identified, 93 in the United Kingdom and 5 in Portugal, of which 46% were aged under 10 years. Cases formed a phylogenetic cluster with a maximum distance of six single nucleotide polymorphisms (SNPs) and average of less than one SNP between isolates. An outbreak investigation was undertaken, including a case–control study. Among the 25 UK cases included in this study, 13 reported blood in stool and 5 were hospitalized. One hundred controls were recruited via a market research panel using frequency matching for age. Multivariable logistic regression analysis of food exposures in cases and controls identified a strong association with cantaloupe consumption (adjusted odds ratio: 14.22; 95% confidence interval: 2.83–71.43; p-value: 0.001). This outbreak, together with other recent national and international incidents, points to an increase in identifications of large outbreaks of Salmonella linked to melon consumption. We recommend detailed questioning and triangulation of information sources to delineate consumption of specific fruit varieties during Salmonella outbreaks.
478 Magnetic Resonance Biomarkers of Metabolic Dysfunction-Associated Steatotic Liver Disease
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- Marissa Brown, Alexander Moody, Juan Vasquez, John Blangero, Luke Norton, Geoffrey Clarke
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- Journal:
- Journal of Clinical and Translational Science / Volume 8 / Issue s1 / April 2024
- Published online by Cambridge University Press:
- 03 April 2024, p. 141
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OBJECTIVES/GOALS: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a major public health concern due to its increasing prevalence and association with type 2 diabetes mellitus. Non-invasive magnetic resonance-based biomarkers can aid in the monitoring of disease progression and identification of patients at risk for chronic liver disease. METHODS/STUDY POPULATION: Over 600 subjects will be recruited from the San Antonio Mexican American Family Study and from a second study, which consists of (i) T2DM patients diagnosed with either MASLD or metabolic dysfunction-associated steatohepatitis (MASH) or (ii) metabolically healthy controls. Hydrogen-1 MRS and diffusion-weighted MRI (DW-MRI) will be used to measure liver fat fraction and liver stiffness biomarkers, respectively. Several potential biomarkers of liver stiffness will be evaluated in vivo using the intravoxel incoherent motion (IVIM) model for DW-MRI. To further improve the diagnostic accuracy of patients with liver fibrosis, we will integrate MRI/MRS data with relevant clinical indicators of hepatic metabolism. Results will be compared to biopsy samples to evaluate the model’s diagnostic accuracy. RESULTS/ANTICIPATED RESULTS: Based on preliminary data, we predict that IVIM will be able to accurately diagnose hepatic fibrosis in patients with MASLD, allowing it to be implemented in clinics with high-field MRI units easily. Previous studies have shown correlations between IVIM estimates and fibrosis stages, however, none included additional clinical indicators of liver disease in their models. We have already found significant differences in metabolic measurements such as fasting plasma glucose and HbA1c levels. Additionally, the use of machine learning in developing these models has shown improvements in the ability to extract features from the data. The aim is to achieve high accuracy and robustness in the staging of liver fibrosis. DISCUSSION/SIGNIFICANCE: Over 100 million people in the US are affected by MASLD. Without treatment, it progresses from hepatic steatosis to MASH, fibrosis (liver stiffening), and ultimately to hepatic cirrhosis and hepatocellular carcinoma (HCC). Continued research efforts and clinical implementation of MRI and MRS are vital in combating the growing burden of MASLD.
RE: Psychosis prediction 2.0: why child and adolescent mental health services should be a key focus for schizophrenia and bipolar disorder prevention research
- Siân Lowri Griffiths, Luke Brown, James B. Kirkbride
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- Journal:
- The British Journal of Psychiatry / Volume 223 / Issue 2 / August 2023
- Published online by Cambridge University Press:
- 01 August 2023, p. 394
- Print publication:
- August 2023
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Chapter 2 - Health Systems Based on Primary Health Care
- from Section 1 - Analyzing Health Systems: Concepts, Components, Performance
- Edited by Sameen Siddiqi, Aga Khan University, Awad Mataria, World Health Organization, Egypt, Katherine D. Rouleau, University of Toronto, Meesha Iqbal, UTHealth School of Public Health, Houston
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- Making Health Systems Work in Low and Middle Income Countries
- Published online:
- 08 December 2022
- Print publication:
- 29 December 2022, pp 20-33
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Summary
This chapter sets out the history, evolution of primary health care (PHC) and discusses its application to contemporary health systems. PHC is a whole-of-society approach to health that aims to maximize the level and distribution of health and well-being through three components: primary care and essential public health functions as the core of integrated health services; multisectoral policy and action; and empowered people and communities. The concept of PHC emerged in the 1960s but was formally codified in the 1978 Alma Ata Declaration. ‘Pragmatic’ reductivism and geopolitical transitions in ensuing decades saw original goals superseded by selective PHC. The World Health Report 2008 – Primary Health Care: Now More Than Ever renewed focus on PHC in the prevailing context of hospital-centrism, commercialization and fragmentation. Mounting evidence on effectiveness, equity and efficiency has made it clear that PHC is the path to achieve universal health coverage and the other health related Sustainable Development Goals. In 2018, governments renewed their commitment to strengthen primary health care in the Declaration of Astana.The WHO and UNICEF Operational Framework for PHC provides guidance for governments to translate these commitments into action.
Segregation and Precipitation at Cell Boundaries in Rapidly Solidified Austenitic Stainless Steels.
- Zachary Hasenbusch, Dallin Barton, Mitchell Roze, Andy Deal, Ben Brown, Davis Wilson, Laurentiu Nastac, Luke Brewer
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- Journal:
- Microscopy and Microanalysis / Volume 27 / Issue S1 / August 2021
- Published online by Cambridge University Press:
- 30 July 2021, pp. 2686-2687
- Print publication:
- August 2021
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Strengthening approaches to respond to the social and emotional well-being needs of Aboriginal and Torres Strait Islander people: the Cultural Pathways Program
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- Tina Brodie, Odette Pearson, Luke Cantley, Peita Cooper, Seth Westhead, Alex Brown, Natasha J Howard
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- Journal:
- Primary Health Care Research & Development / Volume 22 / 2021
- Published online by Cambridge University Press:
- 29 June 2021, e35
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Aboriginal and Torres Strait Islander holistic health represents the interconnection of social, emotional, spiritual and cultural factors on health and well-being. Social factors (education, employment, housing, transport, food and financial security) are internationally described and recognised as the social determinants of health. The social determinants of health are estimated to contribute to 34% of the overall burden of disease experienced by Aboriginal and Torres Strait Islander people. Primary health care services currently ‘do what it takes’ to address social and emotional well-being needs, including the social determinants of health, and require culturally relevant tools and processes for implementing coordinated and holistic responses. Drawing upon a research-setting pilot program, this manuscript outlines key elements encapsulating a strengths-based approach aimed at addressing Aboriginal and Torres Strait Islander holistic social and emotional well-being.
The Cultural Pathways Program is a response to community identified needs, designed and led by Aboriginal and Torres Strait Islander people and informed by holistic views of health. The program aims to identify holistic needs of Aboriginal and Torres Strait Islander people as the starting point to act on the social determinants of health. Facilitators implement strengths-based practice to identify social and cultural needs (e.g. cultural and community connection, food and financial security, housing, mental health, transport), engage in a goal setting process and broker connections with social and health services. An integrated culturally appropriate clinical supervision model enhances delivery of the program through reflective practice and shared decision making. These embedded approaches enable continuous review and improvement from a program and participant perspective. A developmental evaluation underpins program implementation and the proposed culturally relevant elements could be further tailored for delivery within primary health care services as part of routine care to strengthen systematic identification and response to social and emotional well-being needs.
Enhancing the potential effects of text messages delivered via an m-health intervention to improve packing of healthy school lunchboxes
- Alison Brown, Rachel Sutherland, Lisa Janssen, Nayerra Hudson, Amelia Chooi, Renee Reynolds, Alison Walton, Christophe Lecathelinais, Kathryn Reilly, Nicole Nathan, Luke Wolfenden
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- Journal:
- Public Health Nutrition / Volume 24 / Issue 10 / July 2021
- Published online by Cambridge University Press:
- 14 October 2020, pp. 2867-2876
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Objective:
The aim of the study was to assess the impact of different lunchbox messages on parents’ intention to pack a healthy lunchbox.
Design:This study employed an experimental design.
Setting:A series of messages were developed to align with the six constructs of the Health Belief Model. Messages were also developed that were (and were not) personalised and varied based on the source of the information provided (university, school, dietitian and health promotion service). During a telephone survey, participants were read the content of each message and asked about their intention to pack a healthy lunchbox.
Participants:Parents of primary school-aged children were randomised to receive different messages to encourage the packing of healthy lunchboxes.
Results:The study was completed by 511 parents. Linear mixed regression analyses identified significant differences (P < 0·05) in intention scores between variant messages targeting the same behavioural constructs for ‘susceptibility’, ‘severity’, ‘benefits’ and ‘barriers’ but not ‘cues to action’ or ‘self-efficacy’. The highest mean behavioural intention score was for ‘benefits’, whilst the lowest mean score was for ‘barriers’. There were no significant differences in intention scores of parents receiving messages from a dietitian, university, health promotion team or school (P = 0·37). Intention scores did not differ in which messages were personalised based on child’s name (P = 0·84) or grade level (P = 0·54).
Conclusions:The findings suggest that messages that focus on the benefits of packing healthy lunchboxes may be particularly useful in improving intentions of parents to pack healthy foods for their children to consume at school.
A cross-sectional study to determine the energy density and nutritional quality of primary-school children’s lunchboxes
- Rachel Sutherland, Nicole Nathan, Alison Brown, Serene Yoong, Renee Reynolds, Alison Walton, Lisa Janssen, Clare Desmet, Christophe Lecathelinais, Karen Gillham, Vanessa Herrmann, Luke Wolfenden
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- Journal:
- Public Health Nutrition / Volume 23 / Issue 6 / April 2020
- Published online by Cambridge University Press:
- 23 January 2020, pp. 1108-1116
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Objective:
The present study describes the energy content of primary-school children’s lunchboxes and the proportion of lunchbox foods considered discretionary. Subgroup analyses by sex, socio-economic status, age and weight status were undertaken.
Design:A cross-sectional study was conducted. Mean kilojoule content, number of items and categorisation of foods and drinks in lunchboxes as ‘everyday’ (healthy) or discretionary (sometimes) foods were assessed via a valid and reliable lunchbox observational audit.
Setting:Twelve Catholic primary schools (Kindergarten–Grade 6) located in the Hunter region of New South Wales, Australia.
Participants:Kindergarten to Grade 6 primary-school students.
Results:In total, 2143 children (57 %) had parental consent to have their lunchboxes observed. School lunchboxes contained a mean of 2748 kJ, of which 61·2 % of energy was from foods consistent with the Australian Dietary Guidelines and 38·8 % of energy was discretionary foods. The proportion of lunchboxes containing only healthy foods was 12 %. Children in Kindergarten–Grade 2 packed more servings of ‘everyday’ foods (3·32 v. 2·98, P < 0·01) compared with children in Grades 3–6. Children in Grades 3–6 had a higher percentage of energy from discretionary foods (39·1 v. 33·8 %, P < 0·01) compared with children in Kindergarten–Grade 2 and children from the most socio-economically disadvantaged areas had significantly higher total kilojoules in the school lunchbox compared with the least disadvantaged students (2842 v. 2544 kJ, P = 0·03).
Conclusions:Foods packed within school lunchboxes may contribute to energy imbalance. The development of school policies and population-based strategies to support parents overcome barriers to packing healthy lunchboxes are warranted.
Mycobacterium avium pseudo-outbreak associated with an outpatient bronchoscopy clinic: Lessons for reprocessing
- Jessica L. Seidelman, Richard J. Wallace, Jr, Elena Iakhiaeva, Ravikiran Vasireddy, Barbara A. Brown-Elliott, Celeste McKnight, Luke F. Chen, Terry Smith, Sarah S. Lewis
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 40 / Issue 1 / January 2019
- Published online by Cambridge University Press:
- 26 November 2018, pp. 106-108
- Print publication:
- January 2019
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We identified a pseudo-outbreak of Mycobacterium avium in an outpatient bronchoscopy clinic following an increase in clinic procedure volume. We terminated the pseudo-outbreak by increasing the frequency of automated endoscope reprocessors (AER) filter changes from quarterly to monthly. Filter changing schedules should depend on use rather than fixed time intervals.
Nocturnal bird diversity in forest fragments in north-west Ecuador
- Scott T. Walter, Luke Browne, Juan Freile, Nelson González, Julio Loor, Michael Darkes, Thomas W. Gillespie, Jordan Karubian
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- Journal:
- Journal of Tropical Ecology / Volume 33 / Issue 6 / November 2017
- Published online by Cambridge University Press:
- 15 December 2017, pp. 357-364
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Habitat preferences and response to habitat conversion remain under-studied for many groups in the tropics, limiting our understanding of how environmental and anthropogenic factors may interact to shape patterns of diversity. To help fill this knowledge gap, we surveyed nocturnal birds such as owls, nightjars and potoos through auditory transect surveys in 22 forest fragments (2.7 to 33.6 ha) in north-west Ecuador. We assessed the relative effect of habitat characteristics (e.g. canopy height and openness, and density of large trees) and fragment attributes (e.g. area, altitude and proportion of surrounding forest cover) on species richness and community composition. Based on our previous work, we predicted that nocturnal bird richness would be highest in relatively larger fragments with more surrounding forest cover. We recorded 11 total species with an average ± SD of 3.4 ± 1.4 (range = 2–7) species per fragment, with higher richness in fragments that were larger, at lower altitudes, and characterized by more open canopies. Nocturnal bird community similarity was not significantly correlated with any measured environmental variable. These results indicate that both landscape (e.g. altitude) and fragment-specific (e.g. size, forest structure) attributes are likely to interact to shape patterns of diversity among this poorly known but ecologically important guild in fragmented tropical landscapes.
Nutritional predictors of successful chronic disease prevention for a community cohort in Central Australia
- Joanne N Luke, Rebecca Ritte, Kerin O’Dea, Alex Brown, Leonard S Piers, Alicia J Jenkins, Kevin G Rowley
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- Journal:
- Public Health Nutrition / Volume 19 / Issue 13 / September 2016
- Published online by Cambridge University Press:
- 17 November 2015, pp. 2475-2483
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Objective
To investigate biomarkers of nutrition associated with chronic disease absence for an Aboriginal cohort.
DesignScreening for nutritional biomarkers was completed at baseline (1995). Evidence of chronic disease (diabetes, CVD, chronic kidney disease or hypertension) was sought from primary health-care clinics, hospitals and death records over 10 years of follow-up. Principal components analysis was used to group baseline nutritional biomarkers and logistic regression modelling used to investigate associations between the principal components and chronic disease absence.
SettingThree Central Australian Aboriginal communities.
SubjectsAboriginal people (n 444, 286 of whom were without chronic disease at baseline) aged 15–82 years.
ResultsPrincipal components analysis grouped twelve nutritional biomarkers into four components: ‘lipids’; ‘adiposity’; ‘dietary quality’; and ‘habitus with inverse quality diet’. For the 286 individuals free of chronic disease at baseline, lower adiposity, lower lipids and better dietary quality components were each associated with the absence at follow-up of most chronic diseases examined, with the exception of chronic kidney disease. Low ‘adiposity’ component was associated with absence of diabetes, hypertension and CVD at follow-up. Low ‘lipid’ component was associated with absence of hypertension and CVD, and high ‘dietary quality’ component was associated with absence of CVD at follow-up.
ConclusionsLowering or maintenance of the factors related to ‘adiposity’ and ‘lipids’ to healthy thresholds and increasing access to a healthy diet appear useful targets for chronic disease prevention for Aboriginal people in Central Australia.
Contributors
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- By Mark Aronoff, Bernard Bate, Balthasar Bickel, Roger M. Blench, Robert B. Brandom, Penelope Brown, Elizabeth Couper-Kuhlen, Dan Dediu, Mark Dingemanse, R. M. W. Dixon, Penelope Eckert, N. J. Enfield, Paja Faudree, Luke Fleming, Simeon Floyd, Suzanne Gaskins, Ilana Gershon, Susan Goldin-Meadow, Magnus Pharao Hansen, Paul Kockelman, Michael Lempert, Stephen C. Levinson, Paul Manning, Irit Meir, Shaylih Muehlmann, Carol Padden, Keren Rice, Alan Rumsey, Wendy Sandler, Jack Sidnell, Michael Silverstein, Rupert Stasch, David Tavárez, Sandra A. Thompson
- Edited by N. J. Enfield, Paul Kockelman, Yale University, Connecticut, Jack Sidnell, University of Toronto
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- Book:
- The Cambridge Handbook of Linguistic Anthropology
- Published online:
- 05 October 2014
- Print publication:
- 11 September 2014, pp xiii-xiv
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Contributors
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- By James Ahn, Eric L. Anderson, Annette L. Beautrais, Dennis Beedle, Jon S. Berlin, Benjamin L. Bregman, Peter Brown, Suzie Bruch, Jonathan Busko, Stuart Buttlaire, Laurie Byrne, Gerald Carroll, Valerie A. Carroll, Margaret Cashman, Joseph R. Check, Lara G. Chepenik, Robert N. Cuyler, Preeti Dalawari, Suzanne Dooley-Hash, William R. Dubin, Mila L. Felder, Avrim B. Fishkind, Reginald I. Gaylord, Rachel Lipson Glick, Travis Grace, Clare Gray, Anita Hart, Ross A. Heller, Amanda E. Horn, David S. Howes, David C. Hsu, Andy Jagoda, Margaret Judd, John Kahler, Daryl Knox, Gregory Luke Larkin, Patricia Lee, Jerrold B. Leikin, Eddie Markul, Marc L. Martel, J. D. McCourt, MaryLynn McGuire Clarke, Mark Newman, Anthony T. Ng, Barbara Nightengale, Kimberly Nordstrom, Jagoda Pasic, Jennifer Peltzer-Jones, Marcia A. Perry, Larry Phillips, Paul Porter, Seth Powsner, Michael S. Pulia, Erin Rapp, Divy Ravindranath, Janet S. Richmond, Silvana Riggio, Harvey L. Ruben, Derek J. Robinson, Douglas A. Rund, Omeed Saghafi, Alicia N. Sanders, Jeffrey Sankoff, Lorin M. Scher, Louis Scrattish, Richard D. Shih, Maureen Slade, Susan Stefan, Victor G. Stiebel, Deborah Taber, Vaishal Tolia, Gary M. Vilke, Alvin Wang, Michael A. Ward, Joseph Weber, Michael P. Wilson, James L. Young, Scott L. Zeller
- Edited by Leslie S. Zun
- Edited in association with Lara G. Chepenik, Mary Nan S. Mallory
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- Book:
- Behavioral Emergencies for the Emergency Physician
- Published online:
- 05 April 2013
- Print publication:
- 21 March 2013, pp viii-xii
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Perinatal and Early Childhood Outcomes of Twins Versus Triplets
- Barbara Luke, Morton B. Brown, Mary L. Hediger, Ruta B. Misiunas, Elaine Anderson
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- Journal:
- Twin Research and Human Genetics / Volume 9 / Issue 1 / 01 February 2006
- Published online by Cambridge University Press:
- 21 February 2012, pp. 81-88
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The purpose of this prospective cohort study of twins and triplets was to evaluate perinatal and early childhood outcomes through 18 months of age. The study population included 141 twin pregnancies (282 twin children) and 8 triplet pregnancies (24 triplet children) recruited between May, 1996 and June, 2001. Mothers of triplets versus twins were significantly more likely to have infertility treatments, to be overweight or obese before conception, to be admitted antenatally, and to deliver by cesarean section. Length of gestation for triplets was significantly shorter (–2.31 weeks, p < .0001), and more likely to be less than 35 weeks (Adjusted Odds Ratio [AOR] 9.38, 95% confidence interval [CI] 3.22–27.29). Average birthweight for triplets was significantly lighter (–495 grams, p < .0001), and more likely to be low birthweight (AOR 11.38, 95% CI 3.11–41.61). Triplets were also more likely to be admitted to neonatal intensive care (AOR 7.97, 95% CI 2.13–29.77), to require mechanical ventilation (AOR 5.67, 95% CI 2.05–15.65), to develop respiratory distress syndrome (AOR 12.50, 95% CI 3.89–40.20), or a major morbidity (retinopathy of prematurity, necrotizing enterocolitis, ventilator support, or grade III or IV intraventricular hemorrhage, AOR 5.67, 95% CI 2.05–15.65). Weight, length, and head circumference was significantly smaller at birth for triplets compared to twins, and these differences remained through 18 months of age, along with lower mental developmental scores at the oldest age. Compared to twins, triplets have greater neonatal morbidity, and through 18 months of age lower mental and motor scores, slower postnatal growth and more residual stunting, particularly of length and head circumference.
Maternal Risk Factors for Potential Maltreatment Deaths Among Healthy Singleton and Twin Infants
- Barbara Luke, Morton B. Brown
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- Journal:
- Twin Research and Human Genetics / Volume 10 / Issue 5 / 01 October 2007
- Published online by Cambridge University Press:
- 21 February 2012, pp. 778-785
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Our aim was to evaluate the risk of death among healthy infants due to maltreatment, using national linked vital statistics data. The study population included all nonanomalous, full-term (≥ 37 weeks), non-low birthweight (> 2500 grams) infants born between 1995 and 2000 and their linked death certificates: 18,673,439 singleton pregnancies (36,864 deaths) and 77,800 twin pregnancies (356 pregnancies with a death). The underlying cause of death was characterized as due to maltreatment, sudden infant death syndrome (SIDS), and other causes, based on ICD-9 and ICD-10 codes, and modeled by maternal age using multinomial logistic regression; mothers aged 25 to 29 were the reference group. The highest risk for infant mortality was among the youngest mothers for maltreatment (AOR 2.45 and 1.95 for singleton mothers < 20 and aged 20 to 24, respectively; AOR 4.34 and 2.25 for twin mothers < 20 and aged 20 to 24, respectively). The risk of death overall and for each category was modeled by maternal age < 20, aged 20 to 24, and ≥ 25, with and without the father's age present on the birth certificate, with mothers ≥ 25 and father's age present as the reference group. All risks of death were significantly increased for mothers younger than age 25, with the highest risks among the youngest mothers and missing father's age. The pattern for twins was similar, with elevated risks among younger mothers with or without father's age present on the birth certificate. These results add to the body of knowledge regarding risk factors for infant mortality among healthy singletons and twins.
The Hispanic Paradox in Twin Pregnancies
- Barbara Luke, Morton B. Brown, Ruta B. Misiunas, Victor H. Gonzalez-Quintero, Clark Nugent, Cosmas van de Ven, Frank R. Witter, Roger B. Newman, Mary D'Alton, Gary D. V. Hankins, David A. Grainger, George A. Macones
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- Journal:
- Twin Research and Human Genetics / Volume 8 / Issue 5 / 01 October 2005
- Published online by Cambridge University Press:
- 21 February 2012, pp. 532-537
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The objective of this study was to compare length of gestation, fetal growth, and birthweight by race/ethnicity and pregravid weight groups in twin pregnancies. Three thousand and thirty-six twin pregnancies of 28 weeks or more gestation were divided by race/ethnicity (White, Black and Hispanic), and pregravid body mass index (BMI) groups (less than 25.0 vs. 25.0 or more). Outcomes were modeled using multiple regression, controlling for confounders, with White non-Hispanic women as the reference group. Hispanic women had the highest average birthweight and the longest gestation, as well as the lowest proportions of low birthweight, very low birthweight, preterm and early preterm births of the 3 race/ethnicity groups. In the multivariate analyses, Hispanic women had significantly longer gestations (by 7.8 days) and faster rates of fetal growth midgestation (20 to 28 weeks, by 17.4 g/week) and late gestation (after 28 weeks, by 5.3 g/week), whereas Black women had significantly slower rates of fetal growth (by 5.7 g/week and by 4.5 g/week, respectively). These findings in twins reflect the racial and ethnic disparities previously shown in singletons, including the Hispanic paradox of longer gestations and higher rates of fetal growth.
The Effect of Plurality and Gestation on the Prevention or Postponement of Infant Mortality: 1989–1991 Versus 1999–2001
- Barbara Luke, Morton B. Brown
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- Journal:
- Twin Research and Human Genetics / Volume 10 / Issue 3 / 01 June 2007
- Published online by Cambridge University Press:
- 21 February 2012, pp. 514-520
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Advances in perinatal technology that improved survival may have also resulted in prolonged death from the neonatal to the postneonatal period for some infants. The objectives of this study were to determine if the medical advances that occurred in the 1990s benefited infants of multiple births more than their singleton counterparts, and if these changes prevented or postponed mortality for the smallest and most immature infants. The study population included live births of 22 to 43 weeks' gestation from the 1989–1991 and 1999–2001 US Birth Cohort Linked Birth/Infant Death Data Sets. Odds ratios were calculated to evaluate the change in risk by plurality, gestation, and to compare the change to that for singletons. Neonatal and infant mortality rates declined for all pluralities; postneonatal mortality increased for births at less than 26 weeks, but declined at later gestations. In general, the risk of death for twins and triplets compared to singletons decreased, and the improvement in survival was greater for multiples during the early neonatal period and overall. Infant mortality rates improved by 28% for singletons, 32% for twins and triplets during the 1990s, although for the most premature infants, some deaths were postponed from the early to the late neonatal period.
Contributors
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- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. Bernad, Henley Bernard, Alan E. Bernstein, Jon L. Berquist, Johannes Beutler, Ana María Bidegain, Matthew P. Binkewicz, Jennifer Bird, Joseph Blenkinsopp, Dmytro Bondarenko, Paulo Bonfatti, Riet en Pim Bons-Storm, Jessica A. Boon, Marcus J. Borg, Mark Bosco, Peter C. Bouteneff, François Bovon, William D. Bowman, Paul S. Boyer, David Brakke, Richard E. Brantley, Marcus Braybrooke, Ian Breward, Ênio José da Costa Brito, Jewel Spears Brooker, Johannes Brosseder, Nicholas Canfield Read Brown, Robert F. Brown, Pamela K. Brubaker, Walter Brueggemann, Bishop Colin O. Buchanan, Stanley M. Burgess, Amy Nelson Burnett, J. Patout Burns, David B. Burrell, David Buttrick, James P. Byrd, Lavinia Byrne, Gerado Caetano, Marcos Caldas, Alkiviadis Calivas, William J. Callahan, Salvatore Calomino, Euan K. Cameron, William S. Campbell, Marcelo Ayres Camurça, Daniel F. Caner, Paul E. Capetz, Carlos F. Cardoza-Orlandi, Patrick W. Carey, Barbara Carvill, Hal Cauthron, Subhadra Mitra Channa, Mark D. Chapman, James H. Charlesworth, Kenneth R. Chase, Chen Zemin, Luciano Chianeque, Philip Chia Phin Yin, Francisca H. Chimhanda, Daniel Chiquete, John T. Chirban, Soobin Choi, Robert Choquette, Mita Choudhury, Gerald Christianson, John Chryssavgis, Sejong Chun, Esther Chung-Kim, Charles M. A. Clark, Elizabeth A. Clark, Sathianathan Clarke, Fred Cloud, John B. Cobb, W. Owen Cole, John A Coleman, John J. Collins, Sylvia Collins-Mayo, Paul K. Conkin, Beth A. Conklin, Sean Connolly, Demetrios J. Constantelos, Michael A. Conway, Paula M. Cooey, Austin Cooper, Michael L. Cooper-White, Pamela Cooper-White, L. William Countryman, Sérgio Coutinho, Pamela Couture, Shannon Craigo-Snell, James L. Crenshaw, David Crowner, Humberto Horacio Cucchetti, Lawrence S. Cunningham, Elizabeth Mason Currier, Emmanuel Cutrone, Mary L. Daniel, David D. Daniels, Robert Darden, Rolf Darge, Isaiah Dau, Jeffry C. Davis, Jane Dawson, Valentin Dedji, John W. de Gruchy, Paul DeHart, Wendy J. 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