Background The alexithymia trait is of high clinical interest.The Perth Alexithymia Questionnaire(PAQ)was recently developed to enable detailed facet-level and valence-specific assessments of alexithymia.Aims In this ...Background The alexithymia trait is of high clinical interest.The Perth Alexithymia Questionnaire(PAQ)was recently developed to enable detailed facet-level and valence-specific assessments of alexithymia.Aims In this paper,we introduce the first Chinese version of the PAQ and examine its psychometric properties and clinical applications.Methods In Study 1,the PAQ was administered to 990 Chinese participants.We examined its factor structure,internal consistency,test-retest reliability,as well as convergent,concurrent and discriminant validity.In Study 2,four groups,including a major depressive disorder(MDD)group(n=50),a matched healthy control group for MDD(n=50),a subclinical depression group(n=50)and a matched healthy control group for subclinical depression(n=50),were recruited.Group comparisons were conducted to assess the clinical relevance of the PAQ.Results In Study 1,the intended five-factor structure of the PAQ was found to fit the data well.The PAQ showed good internal consistency and test-retest reliability,as well as good convergent,concurrent and discriminant validity.In Study 2,the PAQ was able to successfully distinguish the MDD group and the subclinical depression group from their matched healthy controls.Conclusions The Chinese version of the PAQ is a valid and reliable instrument for comprehensively assessing alexithymia in the general population and adults with clinical/subclinical depression.展开更多
Background Under-five mortality(U5M)is a critical public health challenge in low-and lower-middle-income countries(LLMICs),where over 90%of global deaths occur.Despite progress,the changing contributions of risk facto...Background Under-five mortality(U5M)is a critical public health challenge in low-and lower-middle-income countries(LLMICs),where over 90%of global deaths occur.Despite progress,the changing contributions of risk factors to U5M in LLMICs remain unexplored.Methods We analysed Demographic and Health Survey(DHS)data from 24 LLMICs across two periods:1997–2005 and 2016–2022.We included 139,890 live births in 1997–2005 and 319,034 in 2016–2022.A mixed-effects robust Poisson regression model with a log link function was employed to identify risk factors of U5M in each period.Population-attributable fractions(PAFs)were calculated and compared to investigate changes in the contributions of risk factors over time.Results U5M attributable to never having been breastfed increased by 15.5 percentage points(95%CI 8.6,22.9),early maternal age at birth(<20 years)by 5.4 percentage points(95%CI 3.1,5.7),and plural births by 1.2 percentage points(95%CI 0.4,1.8).U5M reductions attributable to maternal secondary education were increased by 5.5 percentage points(95%CI 0.4,11.0)and tertiary education increased by 2.6 percentage points(95%CI 1.6,4.2).However,U5M reductions associated with 1–3 antenatal care(ANC)visits decreased by 7.2 percentage points(95%CI 2.4,11.7).Conclusions The main contributors of U5M in LLMICs were never breastfeeding,short birth intervals(<33 months),ANC uptake,higher maternal education(secondary and tertiary),advanced maternal age at birth(≥35 years),early maternal age at birth(<20 years),very small infants at birth,male sex,plurality,and single motherhood.The contributions of risk factors to U5M have changed over time.Interventions need to prioritise promoting breastfeeding,enhancing maternal education and increasing ANC uptake,and addressing other significant contributors to U5M.展开更多
Background Early childhood developmental adversities have long-term effects on educational and overall health outcomes.However,the developmental outcomes of children from culturally and linguistically diverse(CALD)bac...Background Early childhood developmental adversities have long-term effects on educational and overall health outcomes.However,the developmental outcomes of children from culturally and linguistically diverse(CALD)backgrounds remain unclear.This study aimed to investigate the association between having a CALD backgrounds and developmental vulnerability in Western Australia.Methods We conducted a retrospective population-based cohort study using data from the Australian Early Development Censuses,Midwives Notification System,and Hospital Morbidity Data Collections.Developmental vulnerability was defined as domain scores<10th percentile in five Australian Early Development Censuses domains.Covariate-adjusted logistic regression,incorporating propensity score weighting,was applied,and the population attributable risk calculations results were informed.Results Among 10,048 CALD children and 49,877 non-CALD children,23.7%[95%confidence interval(CI)22.9,24.5%]of CALD children experienced developmental vulnerability in one or more Australian Early Development Censuses domain(s)(DV1)compared with 19.6%(95% CI 19.3,20.0%)of non-CALD children.Adjusted analyses revealed that CALD children had 23%greater odds of DV1[odds ratio(OR)1.23;95% CI 1.16,1.31]and developmental vulnerability in two or more Australian Early Development Censuses domains(DV2)(OR 1.23;95%CI 1.13,1.33).CALD children had more than twice the odds of vulnerability in terms of communication skills and general knowledge(OR 2.16;95%CI 1.99,2.34)and 37%greater odds in language and cognitive skills(school-based)(OR 1.37;95%CI 1.25,1.51).The population attributable risk was 3.77%for DV1,3.67%for DV2,5.90%for language and cognitive skills(school-based),and 16.24%for communication skills and general knowledge.Conclusions This study revealed a greater developmental vulnerability burden among CALD children than among their non-CALD peers,particularly in the domains of communication skills and general knowledge.Strengthening culturally responsive policies,enhancing early childhood support programs,and ensuring equitable access to educational resources for children from CALD backgrounds may help reduce developmental disparities and promote long-term educational outcomes.展开更多
Background Epidemiological studies examining the direct and indirect effects of gestational diabetes mellitus(GDM)on offspring early childhood developmental vulnerability are lacking.Therefore,the aims of this study w...Background Epidemiological studies examining the direct and indirect effects of gestational diabetes mellitus(GDM)on offspring early childhood developmental vulnerability are lacking.Therefore,the aims of this study were to estimate the direct and indirect effects of GDM(through preterm birth)on early childhood developmental vulnerability.Methods We conducted a retrospective population-based cohort study on the association between gestational diabetes mellitus and early childhood developmental vulnerability in children born in Western Australia(WA)using maternal,infant and birth records from the Midwives Notification,Hospitalizations,Developmental Anomalies,and the Australian Early Development Census(AEDC)databases.We used two aggregated outcome measures:developmentally vulnerable on at least one AEDC domain(DV1)and developmentally vulnerable on at least two AEDC domains(DV2).Causal mediation analysis was applied to estimate the natural direct(NDE),indirect(NIE),and total(TE)effects as relative risks(RR).Results In the whole cohort(n=64,356),approximately 22%were classified as DV1 and 11%as DV2 on AEDC domains.Estimates of the natural direct effect suggested that children exposed to GDM were more likely to be classified as DV1(RR=1.20,95%CI:1.10-1.31)and DV2(RR=1.34,95%CI:1.19-1.50)after adjusting for potential confounders.About 6%and 4%of the effect of GDM on early childhood developmental vulnerability was mediated by preterm birth for DV1 and DV2,respectively.Conclusion Children exposed to gestational diabetes mellitus were more likely to be developmentally vulnerable in one or more AEDC domains.The biological mechanism for these associations is not well explained by mediation through preterm birth.展开更多
INTRODUCTION The United Nations(UN)Decade of Healthy Ageing(2021–2030),coordinated by the World Health Organization(WHO),1 is a global collaborative initiative aimed at improving the lives of older people,their famil...INTRODUCTION The United Nations(UN)Decade of Healthy Ageing(2021–2030),coordinated by the World Health Organization(WHO),1 is a global collaborative initiative aimed at improving the lives of older people,their families and the communities.23 The Action Areas 3(ie,‘deliver person-centred,integrated care and primary health services responsive to older people’)and 4(ie,‘provide access to long-term care(LTC)for older people who need it’)of the Decade’s work programme focus on reorienting health and care systems to promote‘ageing in place’and the delivery of personalised interventions in a seamless continuum of care.展开更多
基金This work was supported by a grant from the National Natural Science Foundation of China(32200906)STI 2030-Major Projects(2021ZD0201705)+2 种基金Major Project of Philosophy and Social Science Research of the Ministry of Education of China(22JZD044)Research Project of Shanghai Science and Technology Commission(20dz2260300)Fundamental Research Funds for the Central Universities and Starting Research Fund from Hangzhou Normal University.
文摘Background The alexithymia trait is of high clinical interest.The Perth Alexithymia Questionnaire(PAQ)was recently developed to enable detailed facet-level and valence-specific assessments of alexithymia.Aims In this paper,we introduce the first Chinese version of the PAQ and examine its psychometric properties and clinical applications.Methods In Study 1,the PAQ was administered to 990 Chinese participants.We examined its factor structure,internal consistency,test-retest reliability,as well as convergent,concurrent and discriminant validity.In Study 2,four groups,including a major depressive disorder(MDD)group(n=50),a matched healthy control group for MDD(n=50),a subclinical depression group(n=50)and a matched healthy control group for subclinical depression(n=50),were recruited.Group comparisons were conducted to assess the clinical relevance of the PAQ.Results In Study 1,the intended five-factor structure of the PAQ was found to fit the data well.The PAQ showed good internal consistency and test-retest reliability,as well as good convergent,concurrent and discriminant validity.In Study 2,the PAQ was able to successfully distinguish the MDD group and the subclinical depression group from their matched healthy controls.Conclusions The Chinese version of the PAQ is a valid and reliable instrument for comprehensively assessing alexithymia in the general population and adults with clinical/subclinical depression.
基金GP was supported with funding from the National Health and Medical Research Council Project and Investigator Grants#1099655 and#1173991GAT was supported with funding from the National Health and Medical Research Council Investigator Grant#1195716+2 种基金ATG was supported with funding by the Western Australian Future Health Research and Innovation Fund through Emerging Leaders Fellowship(Grant ID:WANMA/EL2023-24/7)WANMA Ideas Grant(Grant ID:WANMA/Ideas2023-24/10)the Edith Cowan University Vice-Chancellor Research Fellowship.
文摘Background Under-five mortality(U5M)is a critical public health challenge in low-and lower-middle-income countries(LLMICs),where over 90%of global deaths occur.Despite progress,the changing contributions of risk factors to U5M in LLMICs remain unexplored.Methods We analysed Demographic and Health Survey(DHS)data from 24 LLMICs across two periods:1997–2005 and 2016–2022.We included 139,890 live births in 1997–2005 and 319,034 in 2016–2022.A mixed-effects robust Poisson regression model with a log link function was employed to identify risk factors of U5M in each period.Population-attributable fractions(PAFs)were calculated and compared to investigate changes in the contributions of risk factors over time.Results U5M attributable to never having been breastfed increased by 15.5 percentage points(95%CI 8.6,22.9),early maternal age at birth(<20 years)by 5.4 percentage points(95%CI 3.1,5.7),and plural births by 1.2 percentage points(95%CI 0.4,1.8).U5M reductions attributable to maternal secondary education were increased by 5.5 percentage points(95%CI 0.4,11.0)and tertiary education increased by 2.6 percentage points(95%CI 1.6,4.2).However,U5M reductions associated with 1–3 antenatal care(ANC)visits decreased by 7.2 percentage points(95%CI 2.4,11.7).Conclusions The main contributors of U5M in LLMICs were never breastfeeding,short birth intervals(<33 months),ANC uptake,higher maternal education(secondary and tertiary),advanced maternal age at birth(≥35 years),early maternal age at birth(<20 years),very small infants at birth,male sex,plurality,and single motherhood.The contributions of risk factors to U5M have changed over time.Interventions need to prioritise promoting breastfeeding,enhancing maternal education and increasing ANC uptake,and addressing other significant contributors to U5M.
基金funded by the Australia National Health and Medical Research Council(#1195716)funded by the Australia National Health and Medical Research Council(#1099655 and#1173991).
文摘Background Early childhood developmental adversities have long-term effects on educational and overall health outcomes.However,the developmental outcomes of children from culturally and linguistically diverse(CALD)backgrounds remain unclear.This study aimed to investigate the association between having a CALD backgrounds and developmental vulnerability in Western Australia.Methods We conducted a retrospective population-based cohort study using data from the Australian Early Development Censuses,Midwives Notification System,and Hospital Morbidity Data Collections.Developmental vulnerability was defined as domain scores<10th percentile in five Australian Early Development Censuses domains.Covariate-adjusted logistic regression,incorporating propensity score weighting,was applied,and the population attributable risk calculations results were informed.Results Among 10,048 CALD children and 49,877 non-CALD children,23.7%[95%confidence interval(CI)22.9,24.5%]of CALD children experienced developmental vulnerability in one or more Australian Early Development Censuses domain(s)(DV1)compared with 19.6%(95% CI 19.3,20.0%)of non-CALD children.Adjusted analyses revealed that CALD children had 23%greater odds of DV1[odds ratio(OR)1.23;95% CI 1.16,1.31]and developmental vulnerability in two or more Australian Early Development Censuses domains(DV2)(OR 1.23;95%CI 1.13,1.33).CALD children had more than twice the odds of vulnerability in terms of communication skills and general knowledge(OR 2.16;95%CI 1.99,2.34)and 37%greater odds in language and cognitive skills(school-based)(OR 1.37;95%CI 1.25,1.51).The population attributable risk was 3.77%for DV1,3.67%for DV2,5.90%for language and cognitive skills(school-based),and 16.24%for communication skills and general knowledge.Conclusions This study revealed a greater developmental vulnerability burden among CALD children than among their non-CALD peers,particularly in the domains of communication skills and general knowledge.Strengthening culturally responsive policies,enhancing early childhood support programs,and ensuring equitable access to educational resources for children from CALD backgrounds may help reduce developmental disparities and promote long-term educational outcomes.
基金Open Access funding enabled and organized by CAUL and its Member Institutions.GP was supported with funding from the National Health and Medical Research Council Project and Investigator Grants#1099655 and#1173991the Research Council of Norway through its Centres of Excellence funding scheme#262700GAT was supported with funding from the National Health and Medical Research Council Investigator Grant#1195716.
文摘Background Epidemiological studies examining the direct and indirect effects of gestational diabetes mellitus(GDM)on offspring early childhood developmental vulnerability are lacking.Therefore,the aims of this study were to estimate the direct and indirect effects of GDM(through preterm birth)on early childhood developmental vulnerability.Methods We conducted a retrospective population-based cohort study on the association between gestational diabetes mellitus and early childhood developmental vulnerability in children born in Western Australia(WA)using maternal,infant and birth records from the Midwives Notification,Hospitalizations,Developmental Anomalies,and the Australian Early Development Census(AEDC)databases.We used two aggregated outcome measures:developmentally vulnerable on at least one AEDC domain(DV1)and developmentally vulnerable on at least two AEDC domains(DV2).Causal mediation analysis was applied to estimate the natural direct(NDE),indirect(NIE),and total(TE)effects as relative risks(RR).Results In the whole cohort(n=64,356),approximately 22%were classified as DV1 and 11%as DV2 on AEDC domains.Estimates of the natural direct effect suggested that children exposed to GDM were more likely to be classified as DV1(RR=1.20,95%CI:1.10-1.31)and DV2(RR=1.34,95%CI:1.19-1.50)after adjusting for potential confounders.About 6%and 4%of the effect of GDM on early childhood developmental vulnerability was mediated by preterm birth for DV1 and DV2,respectively.Conclusion Children exposed to gestational diabetes mellitus were more likely to be developmentally vulnerable in one or more AEDC domains.The biological mechanism for these associations is not well explained by mediation through preterm birth.
文摘INTRODUCTION The United Nations(UN)Decade of Healthy Ageing(2021–2030),coordinated by the World Health Organization(WHO),1 is a global collaborative initiative aimed at improving the lives of older people,their families and the communities.23 The Action Areas 3(ie,‘deliver person-centred,integrated care and primary health services responsive to older people’)and 4(ie,‘provide access to long-term care(LTC)for older people who need it’)of the Decade’s work programme focus on reorienting health and care systems to promote‘ageing in place’and the delivery of personalised interventions in a seamless continuum of care.
