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Background: Parental absence in childhood has been associated with multiple negative consequences, such as depression and anxiety in young adulthood., Objective: To assess whether parental absence for six months or more in childhood is associated with poor mental health and substance use in young adulthood and whether parental absence accounts for additional variance beyond those explained by other adverse childhood experiences (ACEs) among youth in sub-Saharan Africa., Participants and Settings: We used combined Violence Against Children and Youth Survey (VACS) data from Cote d'Ivoire (2018), Lesotho (2018), Kenya (2019), Namibia (2019), and Mozambique (2019). Analyses were restricted to 18-24-year-olds (n f  = 7699; n m  = 2482)., Methods: We used logistic regression to examine sex-stratified relationships between parental absence in childhood (defined as biological mother or father being away for six months or more before age 18) and mental health problems and substance use and whether parental absence explained additional variance beyond those explained by other ACEs., Results: In sub-Saharan Africa, parental absence in childhood was common (30.5 % in females and 25.1 % in males), significantly associated with poor mental health and substance use among females and males and accounted for additional variance beyond those explained by conventional ACEs. For example, after controlling for study covariates and other ACEs, females who experienced any parental absence had 1.52 (95 % CI = 1.02-2.26) higher odds of experiencing moderate/serious psychological distress compared with those who did not., Conclusion: The observed association between parental absence and poor mental health suggests that this experience has significant adverse consequences and merits consideration as an ACE., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2023. Published by Elsevier Ltd.)

Background: Adverse Childhood Experiences are traumatic events early in life and have been associated with significant negative health outcomes., Objective: To estimate the prevalence of ACEs in five low- and middle-income sub-Saharan African countries., Participants and Setting: Nationally representative data from the Cote d'Ivoire (2018), Kenya (2019), Lesotho (2018), Mozambique (2019), and Namibia (2019) Violence Against Children and Youth Surveys (VACS) were used. Analyses were restricted to youth ages 18-24 years (n = 8766 females and 2732 males)., Methods: VACS data were analyzed to generate sex-stratified weighted prevalence of individual ACEs (including sexual, physical, and emotional violence; witnessing interparental violence and violence in the community; and orphanhood) and aggregate ACEs (total ACEs; 0, 1-2, and 3 or more), for each country and combined., Results: The most common type of ACEs among both females and males was witnessing physical violence (males: 55.0 % [95 % CI: 51.1-58.8] and females: 37.2 % [95 % CI = 34.3-40.1]) followed by experiencing physical violence (males: 49.7 % [95 % CI = 45.5-53.9] and in females: 36.5 % [95 % CI = 33.8-39.2]). Prevalence of sexual violence was significantly higher in females than in males (16.0 % [95 % CI = 13.9-18.2] vs 8.3 % [95 % CI = 7.0-9.8]; p < 0.001). About 72 % of females and 82 % of males have experienced at least one form of ACE with 20 % of females and 24.2 % of males experiencing 3 or more ACEs., Conclusion: This study demonstrated that majority of the children in countries in sub-Saharan Africa have experienced multiple ACEs in their lifetime. Understanding the extent of the problem will help design early interventions to reduce childhood exposure to ACEs or mitigate against the harmful impact of ACEs., (Copyright © 2023. Published by Elsevier Ltd.)

Tibiotarsal fractures are a common presentation in small bird species and anecdotally have been reported to carry a good prognosis with proper treatment, such as external coaptation. For this retrospective study, the medical records of 5 institutions were reviewed for tibiotarsal fractures diagnosed in companion birds weighing less than 200 g. A total of 86 cases met the inclusion criteria. Cockatiels ( Nymphicus hollandicus) (24/86) and budgerigars ( Melopsittacus undulatus) (19/86) were the most frequently represented species. Median body weight of the birds included was 72 g (range, 16-182 g). Mid-diaphyseal (46/86) and closed (73/86) fractures with intact, deep pain sensation in the affected limb (69/76) were most frequent. A tape splint alone (79/86) or a tape splint in addition to an intramedullary pin (7/86) were applied in all cases. Median time to fracture stabilization based on palpation was 19 days (range, 7-49 days). In most cases (61/86), the initial splint applied was maintained until fracture healing was complete. A successful outcome was documented in 92% (79/86) of birds. Fractures caused by a dog or cat attack, birds presenting without deep pain sensation in the affected limb, and cases where the splint was removed before 14 days after fixation were associated with a significantly increased risk of complications, resulting in an unsuccessful outcome. The findings of this study indicated that a tape splint is an appropriate means for treatment of tibiotarsal fractures in birds weighing less than 200 g.

Objective: To develop transparent and reproducible methods for imputing missing data on disease incidence at national-level for the year 2005., Methods: We compared several models for imputing missing country-level incidence rates for two foodborne diseases - congenital toxoplasmosis and aflatoxin-related hepatocellular carcinoma. Missing values were assumed to be missing at random. Predictor variables were selected using least absolute shrinkage and selection operator regression. We compared the predictive performance of naive extrapolation approaches and Bayesian random and mixed-effects regression models. Leave-one-out cross-validation was used to evaluate model accuracy., Findings: The predictive accuracy of the Bayesian mixed-effects models was significantly better than that of the naive extrapolation method for one of the two disease models. However, Bayesian mixed-effects models produced wider prediction intervals for both data sets., Conclusion: Several approaches are available for imputing missing data at national level. Strengths of a hierarchical regression approach for this type of task are the ability to derive estimates from other similar countries, transparency, computational efficiency and ease of interpretation. The inclusion of informative covariates may improve model performance, but results should be appraised carefully.