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Intervention studies often assume that changes in an outcome are homogenous across the population, however this assumption might not always hold. This article describes how latent class growth modelling (LCGM) can be performed in intervention studies, using an empirical example, and discusses the challenges and potential implications of this method. The analysis included 110 young adults with mobility disability that had participated in a parallel randomized controlled trial and received either a mobile app program (n = 55) or a supervised health program (n = 55) for 12 weeks. The primary outcome was accelerometer measured moderate to vigorous physical activity (MVPA) levels in min/day assessed at baseline, 6 weeks, 12 weeks, and 1-year post intervention. The mean change of MVPA from baseline to 1-year was estimated using paired t-test. LCGM was performed to determine the trajectories of MVPA. Logistic regression models were used to identify potential predictors of trajectories. There was no significant difference between baseline and 1-year MVPA levels (4.8 min/day, 95% CI: -1.4, 10.9). Four MVPA trajectories, 'Normal/Decrease', 'Normal/Increase', 'Normal/Rapid increase', and 'High/Increase', were identified through LCGM. Individuals with younger age and higher baseline MVPA were more likely to have increasing trajectories of MVPA. LCGM uncovered hidden trajectories of physical activity that were not represented by the average pattern. This approach could provide significant insights when included in intervention studies. For higher accuracy it is recommended to include larger sample sizes., Author(s): Anna-Maria Lampousi [sup.1] [sup.2] , Jette Möller [sup.1] , Yajun Liang [sup.1] , Daniel Berglind [sup.1] , Yvonne Forsell [sup.1] Author Affiliations: (1) grid.4714.6, 0000 0004 1937 0626, Department [...]

Objectives: The Major Depression Inventory (MDI) was constructed to assess DSM‐IV and ICD‐10 depression symptoms, and does not fully cover the symptoms listed in DSM‐5 and ICD‐11. This study aimed to augment the MDI to the new diagnostic standards by adding a new item, and to assess and compare the measurement performance of the MDI items and diagnostic algorithms for major depression according to DSM‐IV, ICD‐10, DSM‐5 and ICD‐11. Methods: Surveys collected 2001–2003 and 2021, including self‐assessed MDI were used. A new hopelessness item was constructed and analyzed alongside the hopelessness item in the Symptom Checklist. The performance of items was compared using Rasch and Mokken analyses. Criterion validity was examined using equivalent diagnoses from psychiatric interview (Schedules for Clinical Assessments in Neuropsychiatry [SCAN]) as standard. Results: MDI information was provided by 8511 individuals in 2001–2003 (SCAN subsample n = 878), and 8863 in 2021. All items, including hopelessness had good psychometric properties. Sensitivity ranged between 56% and 70%, and specificity between 95% and 96%, indicating similar criterion validity. Conclusions: Hopelessness and the MDI items had good psychometrics. MDI for DSM‐5 and ICD‐11 had similar validity as for DSM‐IV and ICD‐10. We recommend that MDI is updated to DSM‐5 and ICD‐11 by adding a hopelessness item. [ABSTRACT FROM AUTHOR]

(1) Background: Potentially inappropriate medications (PIMs) in older adults are associated with drug-related problems, adverse health consequences, repeated hospital admissions and a higher risk of mortality. In Saudi Arabia and some Arab countries, studies of PIMs among large cohorts of older adults are limited. This study aimed to determine the prevalence of PIMs, trends and associated factors among outpatient older adults in Saudi Arabia. (2) Methods: A cross-sectional study was carried out. Over three years (2017–2019), data on 23,417 people (≥65 years) were retrieved from outpatient clinics in a tertiary hospital in Riyadh, Saudi Arabia. PIMs were assessed using the 2019 Beers Criteria. Covariates included sex, age, nationality, number of dispensed medications, and number of diagnoses. A generalized estimating equation model was used to assess trends and factors associated with PIMs. (3) Results: The prevalence of PIMs was high and varied between 57.2% and 63.6% over the study years. Compared with 2017, the prevalence of PIMs increased significantly, with adjusted odds ratios (OR) (95% confidence interval (95% CI)) of 1.23 (1.18–1.29) and 1.15 (1.10–1.21) for 2018 and 2019, respectively. Factors associated with being prescribed PIMs included ≥5 dispensed medications (OR_adjusted = 23.91, 95% CI = 21.47–26.64) and ≥5 diagnoses (OR_adjusted = 3.20, 95% CI = 2.88–3.56). Compared with females, males had a lower risk of being prescribed PIMs (OR_adjusted = 0.90, 95% CI = 0.85–0.94); (4) Conclusions: PIMs were common with an increasing trend among older adults in Saudi Arabia. A higher number of dispensed medications, increased number of diagnoses and female sex were associated with being prescribed PIMs. Recommendations on how to optimize prescriptions and implement de-prescribing strategies are urgently needed. [ABSTRACT FROM AUTHOR]

Background: Hospitals from resource-scarce countries encounter significant barriers to the provision of injury care, particularly for children. Shortages in material and human resources are seldom documented, not least in African settings. This study analyzed pediatric injury care resources in Mozambique hospital settings. Methods: We undertook a cross-sectional study, encompassing the country's four largest hospitals. Data was collected in November 2020 at the pediatric emergency units. Assessment of the resources available was made with standardized WHO emergency equipment and medication checklists, and direct observation of premises and procedures. The potential impact of unavailable equipment and medications in pediatric wards was assessed considering the provisions of injury care. Results: There were significant amounts of not available equipment and medications in all hospitals (ranging from 20% to 49%) and two central hospitals stood out in that regard. The top categories of not available equipment pertained to diagnosis and monitoring, safety for health care personnel, and airway management. Medications to treat infections and poisonings were those most frequently not available. There were several noteworthy and life-threatening shortcomings in how well the facilities were equipped for treating pediatric patients. The staff regarded lack of equipment and skills as the main obstacles to delivering quality injury care. Further, they prioritized the implementation of trauma courses and the establishment of trauma centers to strengthen pediatric injury care. Conclusion: The country's four largest hospitals had substantial quality-care threatening shortages due to lack of equipment and medications for pediatric injury care. All four hospitals face issues that put at risk staff safety and impede the implementation of essential care interventions for injured children. Staff wishes for better training, working environments adequately equipped and well-organized. The room for improvement is considerable, the study results may help to set priorities, to benefit better outcomes in child injuries. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to examine whether changes in alcohol consumption over time differ according to beverage types, and to what extent socioeconomic, lifestyle and health-related factors predict beverage-specific trajectories in Sweden. Study design: We included participants from the Stockholm Public Health Cohort who were surveyed repeatedly in 2002, 2010 and 2014. Alcohol consumption trajectories were constructed for 13,152 individuals with valid information on amount and frequency of drinking. Preferred beverage types (i.e., beer, wine or spirits) were defined based on the most consumed beverages. Multinomial logistic regression was used to quantify individual predictors of different trajectories, overall and by beverage type. Results: Overall 56.9% of respondents were women, the mean age was 49.2 years, SD (13.1). Wine was cited as the preferred beverage for 72.4% of participants, and stable moderate drinking was the most common trajectory regardless of beverage type (68.2%, 54.9% and 54.2% in individuals with wine, beer and spirits as preferred beverages, respectively). Associations between drinking trajectories and baseline lifestyle factors did not differ by beverage type. Lower socioeconomic position (SEP) was associated with unstable moderate wine drinking (for unskilled manual SEP: adjusted odds ratio [aOR] 1.54, 95% confidence interval [CI] 1.23, 1.93), unstable heavy beer drinking (for skilled manual SEP: aOR 1.99, 95% CI 1.14, 3.52; and unskilled manual SEP: aOR 1.72, 95% CI 1.05, 2.82), and former beer drinking trajectory (for skilled manual SEP: aOR 1.81; 95% CI 1.21, 2.72; and unskilled manual SEP: aOR 1.66; 95% CI 1.17, 2.37). Conclusion: Lower SEP was associated with unstable heavy drinking of beer, former beer drinking, and unstable moderate wine drinking trajectories indicating that targeted alcohol prevention programmes need to focus on these groups. [ABSTRACT FROM AUTHOR]

Aim: Psychotropic drugs like opioids and benzodiazepines are prescribed for traumas resulting from road traffic crashes and the risk of developing an addiction deserves consideration. This study aims to shed light on how the consumption of those drugs evolves over time among older road traffic injury (RTI) victims. Methods: We conducted a nationwide Swedish register‐based longitudinal study to identify trajectories of post‐RTI psychotropic drug use. All individuals aged 50 years and older who had a hospital visit for an RTI from 2007 to 2015 were followed up during a 2‐year period; those who used the drugs prior to the RTI were excluded. Trajectories were identified by performing latent class trajectory analysis on drug dispensation data for opioids and benzodiazepines separately (66 034 and 66 859 adults, respectively, in total). Results: Three trajectories were identified for opioids and four for benzodiazepines. The largest group in both instances included people with no‐use/minimal use throughout the follow‐up (81.3% and 92.8%). "Sporadic users" were more frequent among users of opioids (16.7%) than benzodiazepines (4.3%), whereas "chronic users" were found in similar proportions (2.0% and 1.8%). "Delayed chronic use" characterized the fourth group of benzodiazepine users (1.0%). Conclusion: Several trajectories of psychotropic drug use were identified after RTI, from limited to chronic. Although chronic use was uncommon, a better understanding of the factors likely to increase that risk is warranted given the seriousness of the problem. [ABSTRACT FROM AUTHOR]

Background: Commercial motorcycling transportation business is an important source of employment in many low- and middle-income countries. The working conditions related to, low earnings, job insecurity, and lack of income guarantee may put drivers at greater risk of road traffic injuries (RTIs). Objectives: To determine the associations between different types of ownership of motorcycle and the risk of RTIs, with risky driving behaviours, the number of working hours and motorcycle conditions as potential mediators among commercial motorcycle drivers. Methods: A case-control study was conducted among 164 cases and 400 controls of commercial motorcycle drivers in the city of Dar es Salaam. Cases were identified at the hospitals, and controls were randomly selected from the parking stages of commercial motorcycle drivers. The associations between the types of ownership of motorcycles and the risk of RTIs were assessed using univariate and multivariate logistic regression. Mediation analysis was used to assess to what extent risky driving behaviors, number of working hours and the motorcycle conditions mediate the associations between types of ownership of motorcycles and the risk of RTIs. Odds ratio with 95% confidence intervals was used to present the effect size. Results: The odds ratio for RTIs was significantly higher among drivers who co-owned their motorcycles (OR=3.42, 95% CI: 1.94 -6.02) and rented (OR=2.05, 95% CI: 1.25-3.48) compared to drivers who owned their motorcycles after adjustment for sociodemographic characteristics and years of driving experience. Risky driving behaviors significantly mediated the relationships between the risk of RTIs and the rented motorcycle drivers (indirect effect: (OR=1.24, 95% CI: 1.09-1.40), while the number of working hours mediated the relationships of the risk of RTIs and the co-owner motorcycle drivers (indirect effect; OR=1.19, 95% CI: 1.06 - 1.34) compared to those who owned their motorcycles. Conclusion and recommendations: The results suggest an association between types of ownership of motorcycles and RTIs, with the highest risk found to be among co-owned and rented motorcycle drivers. Additionally, risky driving behaviours partially explained the relationships between the risk of RTIs and drivers operating rented motorcycles, while the number of working hours mediated the relationships between the risk of RTIs and co-owned motorcycles drivers. These findings suggest further investigation of challenges of the working conditions of the commercial motorcycle drivers as a precarious job in order to reduce the burden of RTIs. There is a need of developing a policy for regulating motorcycling business as informal job to reduce the burden of the RTIs among motorcyclists and other road users [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to examine whether changes in alcohol consumption over time differ according to beverage types, and to what extent socioeconomic, lifestyle and health-related factors predict beverage-specific trajectories in Sweden. Study design: We included participants from the Stockholm Public Health Cohort who were surveyed repeatedly in 2002, 2010 and 2014. Alcohol consumption trajectories were constructed for 13,152 individuals with valid information on amount and frequency of drinking. Preferred beverage types (i.e., beer, wine or spirits) were defined based on the most consumed beverages. Multinomial logistic regression was used to quantify individual predictors of different trajectories, overall and by beverage type. Results: Overall 56.9% of respondents were women, the mean age was 49.2 years, SD (13.1). Wine was cited as the preferred beverage for 72.4% of participants, and stable moderate drinking was the most common trajectory regardless of beverage type (68.2%, 54.9% and 54.2% in individuals with wine, beer and spirits as preferred beverages, respectively). Associations between drinking trajectories and baseline lifestyle factors did not differ by beverage type. Lower socioeconomic position (SEP) was associated with unstable moderate wine drinking (for unskilled manual SEP: adjusted odds ratio [aOR] 1.54, 95% confidence interval [CI] 1.23, 1.93), unstable heavy beer drinking (for skilled manual SEP: aOR 1.99, 95% CI 1.14, 3.52; and unskilled manual SEP: aOR 1.72, 95% CI 1.05, 2.82), and former beer drinking trajectory (for skilled manual SEP: aOR 1.81; 95% CI 1.21, 2.72; and unskilled manual SEP: aOR 1.66; 95% CI 1.17, 2.37). Conclusion: Lower SEP was associated with unstable heavy drinking of beer, former beer drinking, and unstable moderate wine drinking trajectories indicating that targeted alcohol prevention programmes need to focus on these groups., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)