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Li L, Liu Y, Chen Z, Ren S, He R, Liang Y, Tan Y, Shao X, Chen S, Kong X, Tang J, Chen X, Liao Y. Gender differences in alcohol drinking among adolescents: a school-based survey in China. BMJ Open 2024; 14:e080687. [PMID: 38553083 PMCID: PMC10982719 DOI: 10.1136/bmjopen-2023-080687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 03/21/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Alcohol drinking among adolescents is associated with their health development. However, the prevalence of alcohol drinking among adolescents in Southwestern China remains largely unexplored. This study aimed to investigate the prevalence of alcohol drinking, with a particular focus on gender differences, among primary and middle school students in Zigong, a city in Southwestern China. Additionally, we examined the association between alcohol consumption and demographic and family factors. METHODS A school-based cross-sectional survey was conducted in a city in Southwestern China, encompassing a total of 89 360 students from 132 different ordinary schools, including both primary and middle schools. Participants were recruited through cluster sampling. The Alcohol Use Disorders Identification Test Consumption was employed to assess alcohol consumption. Gender differences in the prevalence of alcohol drinkers across various schools and grades were analysed. Multivariable logistic regression analysis was used to investigate factors associated with hazardous drinking. RESULTS Out of the 89 360 participants, 19.0% reported alcohol drinking, with 2.1% classified as hazardous drinkers. There was a higher prevalence of alcohol drinking among boys compared with girls, as well as hazardous drinking. There were significant gender disparities in alcohol drinking observed across various schools and grade levels. A notable divergence between boys and girls was observed starting from grade 10, with a rising prevalence of hazardous drinking among boys and a decline among girls. Additionally, older age, male gender and being left-behind children were identified as risk factors for hazardous drinking, while belonging to a nuclear family and having parents who do not drink were protective factors against hazardous drinking. CONCLUSIONS Alcohol consumption is prevalent among Chinese adolescents, with some even classified as hazardous drinkers. These findings may offer valuable insights for policymakers and caregivers, guiding them in formulating appropriate interventions and support strategies.
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Affiliation(s)
- Ling Li
- Department of Psychiatry, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China
| | - Yi Liu
- Department of Psychiatry, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China
| | - Zhangming Chen
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Silan Ren
- Department of Nursing, Sichuan Vocational College of Health and Rehabilitation, Zigong, Sichuan, China
| | - Ruini He
- Department of Psychiatry, Zigong Mental Health Center, Zigong, Sichuan, China
| | - Yudiao Liang
- Department of Psychiatry, Zigong Mental Health Center, Zigong, Sichuan, China
| | - Youguo Tan
- Department of Psychiatry, Zigong Mental Health Center, Zigong, Sichuan, China
| | - Xu Shao
- Department of Psychiatry, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China
| | - Shanshan Chen
- Department of Psychiatry, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China
| | - Xiangjuan Kong
- Department of Psychiatry, Daizhuang Hospital, Jining, Shandong, China
| | - Jinsong Tang
- Department of Psychiatry, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China
| | - Xiaogang Chen
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yanhui Liao
- Department of Psychiatry, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China
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Buli BG, Lehtinen-Jacks S, Larm P, Nilsson KW, Hellström-Olsson C, Giannotta F. Trends in psychosomatic symptoms among adolescents and the role of lifestyle factors. BMC Public Health 2024; 24:878. [PMID: 38515098 PMCID: PMC10958834 DOI: 10.1186/s12889-024-18327-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/11/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Adolescent mental health problems are on the rise globally, including in Sweden. One indicator of this trend is increased psychosomatic symptoms (PSS) over time. Lifestyle factors such as physical activity (PA), diet, smoking, and alcohol consumption may influence the time trends in PSS; however, the evidence base is scarce. The aim of this study was to investigate associations between time trends in PSS and lifestyle factors. METHODS The study was based on data collected from a nationally representative sample of 9,196 fifteen-year-old boys and girls in Sweden using the Health Behavior in School-aged Children (HBSC) symptom checklist. The sample comprised nearly equal proportions of girls (50.5%) and boys. The lifestyle factors examined in this study included PA, regular breakfast intake, consumption of fruits, vegetables, sweets, or soft drinks, smoking, and alcohol drunkenness. We used data from 2002 to 2018 and stratified by family affluence scale (FAS) to demonstrate how the associations varied among the FAS groups. We fitted separate regression models for the high- and low-FAS groups, where interaction terms between the year of survey and each lifestyle factor were used to estimate the level and direction of associations between the factors and trends in PSS. RESULTS There was a generally increasing trend in PSS mean scores from 2.26 in 2002 to 2.49 in 2018 (p <.001). The changes in each survey year compared to the average mean scores during the preceding years were significant in all years except 2010. Regular breakfast intake, daily fruit and vegetable consumption, and higher PA were associated with lower PSS mean scores, while smoking and drunkenness had opposite associations with PSS. The only significant interaction between survey year and the lifestyle factors was observed regarding drunkenness in the high FAS group, suggesting that the association between trends in PSS and the experience of getting drunk at least twice got stronger over time (B = 0.057; CI:0.016, 0.097; p <.01). CONCLUSIONS The results indicate increasing trends in PSS among young people in Sweden from 2002 to 2018, with a significant increase observed among adolescents in the high FAS group who reported getting drunk on at least two occasions.
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Affiliation(s)
- Benti Geleta Buli
- Department of Public Health Sciences, Mälardalen University, 721 23, Västerås, Box 883, Sweden.
| | - Susanna Lehtinen-Jacks
- Department of Public Health Sciences, Mälardalen University, 721 23, Västerås, Box 883, Sweden
| | - Peter Larm
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Kent W Nilsson
- Department of Public Health Sciences, Mälardalen University, 721 23, Västerås, Box 883, Sweden
- Center for Clinical Research, Uppsala University, Västmanland County Hospital, Uppsala, Sweden
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | | | - Fabrizia Giannotta
- Department of Public Health Sciences, Mälardalen University, 721 23, Västerås, Box 883, Sweden
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Department of Psychology, University of Turin, Turin, Italy
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Gardner LA, Stockings E, Champion KE, Mather M, Newton NC. Alcohol initiation before age 15 predicts earlier hazardous drinking: A survival analysis of a 7-year prospective longitudinal cohort of Australian adolescents. Addiction 2024; 119:518-529. [PMID: 37926434 DOI: 10.1111/add.16376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 09/19/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND AND AIMS Early alcohol use may predict later alcohol problems, but the magnitude of this effect and impact of delayed onset remain uncertain. This study measured age-based differences in progression from first full alcoholic drink to hazardous drinking in one of the largest and most recent prospective cohorts of Australian adolescents. DESIGN, SETTINGS, PARTICIPANTS AND MEASUREMENT A 7-year (2012-19) prospective longitudinal cohort of 2082 Australian adolescents was established from the Climate and Preventure (cohort 1) and Climate Schools Combined (cohort 2) studies. Participants completed surveys annually from ages 13 to 20 years. Interval censored survival analyses were conducted with first episode of hazardous drinking [three or more on proxy Alcohol Use Disorders Identification Test (AUDIT-C)] as the survival end-point, controlling for age, sex and mental health symptomatology. Onset of hazardous drinking was expressed as hazard ratios (HRs), and median survival time (years) was used to model first onset of hazardous alcohol use in survival curves. FINDINGS Compared with those aged 15 or older, those who had their first full drink at 12 or younger had significantly elevated risk of hazardous drinking onset during the study period [log (HR): 9.3; 95% confidence interval (CI) = 7.0-12.0, P < 0.001]. Compared with those who had their first full drink at ages 13-14, those who delayed until 15 or older had significantly later onset of hazardous drinking; 1.63 years for males (95% CI = 1.31-1.92, P < 0.001) and 1.50 for females (95% CI = 1.15-1.81, P < 0.001), resulting in a median age of onset of hazardous drinking of > 19 for both sexes (male: 19.05 years, 95% CI = 18.74-19.38; female: 19.47 years, 95% CI = 19.19-19.75). First drink at ages 13-14 was associated with the earliest onset of hazardous drinking (males: 17.43 years; females: 17.98 years). CONCLUSIONS In Australia, alcohol initiation prior to age 15 appears to be associated with an earlier onset of hazardous drinking than initiation after age 15.
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Affiliation(s)
- Lauren A Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Emily Stockings
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Katrina E Champion
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Marius Mather
- Sydney Informatics Hub, University of Sydney, Sydney, Australia
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
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Cerocchi N, Mojica-Perez Y, Livingston M, Arunogiri S, Pennay A, Callinan S. Examining the association between psychological distress and alcohol use in Australian adolescents over a period of declining consumption. Drug Alcohol Rev 2024; 43:633-642. [PMID: 37399136 DOI: 10.1111/dar.13703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 05/05/2023] [Accepted: 05/29/2023] [Indexed: 07/05/2023]
Abstract
INTRODUCTION Youth drinking rates have declined over the past 15 years while self-reported psychological distress has increased, despite a well-recognised positive relationship between the two. The current study aimed to identify changes in the relationship between psychological distress and alcohol use in adolescents from 2007 to 2019. METHODS This study used survey responses from 6543 Australians aged 14-19 years who completed the National Drug Strategy Household Survey in 2007, 2010, 2013, 2016 or 2019. Logistic and multivariable linear regressions with interactions (psychological distress × survey wave) predicted any alcohol consumption, short-term risk and average quantity of standard drinks consumed per day. RESULTS Psychological distress was a positive predictor of alcohol use and this association remained stable across survey waves as alcohol consumption decreased. DISCUSSION AND CONCLUSIONS The relationship between distress and alcohol consumption remained relatively steady, even as youth drinking declined and distress increased. The proportion of drinkers experiencing distress did not increase as consumption rates dropped, suggesting that the decline in youth drinking is occurring independently of the increase in self-reported and diagnosed mental health issues.
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Affiliation(s)
- Natalie Cerocchi
- Department of Psychology, Counselling and Therapy, La Trobe University, Melbourne, Australia
| | - Yvette Mojica-Perez
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Michael Livingston
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
- National Drug Research Institute, Curtin University, Perth, Australia
- Centre for Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Shalini Arunogiri
- Turning Point, Eastern Health, Melbourne, Australia
- Monash Addiction Research Centre and Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Amy Pennay
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Sarah Callinan
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
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Sims SA, Pereira G, Fatovich DM, Preen D, O'Donnell M. Assessing the utility of night-time presentations as a proxy for alcohol-related harm among young emergency department trauma patients. Emerg Med Australas 2024; 36:47-54. [PMID: 37577775 PMCID: PMC10952259 DOI: 10.1111/1742-6723.14294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 07/03/2023] [Accepted: 07/31/2023] [Indexed: 08/15/2023]
Abstract
OBJECTIVE To assess the usefulness of night-time presentations to measure alcohol-related harm (ARH) in young trauma patients, aged 12-24 years, attending Western Australian EDs. METHODS A retrospective longitudinal study examined alcohol-related ED presentations in Western Australia (WA; 2002-2016) among 12- to 24-year-olds. Data from the Emergency Department Data Collection, WA State Trauma Registry Database and Hospital Morbidity Data Collection were used to identify ARH through specific codes and text searches. These were compared to ARH estimates based on presentation time. Statistical analysis involved sensitivity and specificity calculations and Cox proportional hazards modelling. RESULTS We identified 2644 (17.8%) night-time presentations as a proxy measure of ARH among the 14 887 presentations of patients aged 12-24 years. This closely matched the 3064 (20.6%) identified as ARH through coding methods. The highest risk for an ARH presentation occurred during the night hours between 00.00 and 04.59 hours. During these hours, the risk was 4.4-5.1 times higher compared to presentations at midday (between 12.00 and 12.59 hours). However, when looking at individual patients, we observed that night-time presentations were not a strong predictor of ARH (sensitivity: 0.39; positive predictive value: 0.46). CONCLUSIONS Implementing targeted interventions during night hours could be beneficial in addressing ARH presentations. However, relying solely on the time of presentation as a proxy for ARH is unlikely to effectively identify ARH in young individuals. Instead, the present study emphasises the importance of implementing mandatory data collection strategies in EDs to ensure accurate measurement of ARH cases.
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Affiliation(s)
- Scott A Sims
- School of Population and Global HealthThe University of Western AustraliaPerthWestern AustraliaAustralia
| | - Gavin Pereira
- Curtin School of Population HealthCurtin UniversityPerthWestern AustraliaAustralia
- Centre for Fertility and HealthNorwegian Institute of Public HealthOsloNorway
| | - Daniel M Fatovich
- Emergency Medicine, Royal Perth HospitalThe University of Western AustraliaPerthWestern AustraliaAustralia
- Centre for Clinical Research in Emergency MedicineHarry Perkins Institute of Medical ResearchPerthWestern AustraliaAustralia
| | - David Preen
- School of Population and Global HealthThe University of Western AustraliaPerthWestern AustraliaAustralia
| | - Melissa O'Donnell
- School of Population and Global HealthThe University of Western AustraliaPerthWestern AustraliaAustralia
- Australian Centre for Child ProtectionUniversity of South AustraliaAdelaideSouth AustraliaAustralia
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Yan K, Feng Y, Liu Z, Shi W, Jiang Y, Liu J. Impulsivity Drives Adolescents to Smoke and Drink: Gender Differences in the Mediating Effects of Resilience and Depression. Psychol Rep 2023:332941231216894. [PMID: 37982432 DOI: 10.1177/00332941231216894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
High and rising rates of smoking and drinking among Chinese adolescents are contributing to increasingly serious physical and mental health issues. While impulsivity has been demonstrated to be significantly related to adolescent cigarette and alcohol use, little is known about the mechanisms behind this association. The current study focused on resilience and depressive symptoms as potential mediators of this link, exploring the indirect pathways connecting impulsivity to teenage tobacco and alcohol use. Possible gender differences in this indirect pathway were also explored. Participants were secondary school students from southern China (N = 3466; 49.2% were female; Mage = 14.18; SDage = 1.57). Results revealed that adolescents who were more impulsive used cigarettes and alcohol more frequently, and that this effect was partially mediated by lower resilience and more depressive symptoms. It is noteworthy that there were gender differences in this mediating effect, with the effect of impulsivity on cigarette use for girls being mediated by resilience and depressive symptoms, whereas this statistically significant association was not identified for boys. These findings show how adolescents' impulsivity drives them to smoke and drink, and also emphasize gender as a crucial consideration for intervening with adolescents' drinking and smoking behaviors.
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Affiliation(s)
- Kai Yan
- School of Educational Science, Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China
| | - Yonghui Feng
- School of Educational Science, Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China
| | - Ziyao Liu
- School of Educational Science, Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China
| | - Wei Shi
- School of Educational Science, Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China
| | - Yubin Jiang
- School of Educational Science, Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China
| | - Juan Liu
- School of Educational Science, Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China
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Guckel T, Miller CL, Longo M, Cooke R, Bowden JA. Alcohol consumption and mental health conditions: Insights from a South Australian population survey to inform policy and practice. Aust N Z J Public Health 2022; 46:668-675. [DOI: 10.1111/1753-6405.13277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 03/01/2022] [Accepted: 05/01/2022] [Indexed: 11/28/2022] Open
Affiliation(s)
- Tara Guckel
- School of Public Health University of Adelaide South Australia
- The Matilda Centre for Research in Mental Health and Substance Use The University of Sydney New South Wales
| | - Caroline L. Miller
- School of Public Health University of Adelaide South Australia
- South Australian Health and Medical Research Institute Adelaide South Australia
| | - Marie Longo
- Drug and Alcohol Services South Australia Stepney South Australia
| | - Richard Cooke
- Drug and Alcohol Services South Australia Stepney South Australia
| | - Jacqueline A. Bowden
- School of Public Health University of Adelaide South Australia
- South Australian Health and Medical Research Institute Adelaide South Australia
- National Centre for Education and Training on Addiction Bedford Park South Australia
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Gavurova B, Tarhanicova M. Young Adults and Sick Leave Length of Mental Illnesses. Front Public Health 2022; 10:882707. [PMID: 35769771 PMCID: PMC9234197 DOI: 10.3389/fpubh.2022.882707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivesThe objective was to explore whether a sick leave length related to mental morbidity differs across different occupational categories.MethodsIn the analysis, registry of sick leaves was analyzed. Provided analysis is focused on the length of sick leaves related to mental diseases caused by substance use or other factors. Dependent variable is the sick leave length, and the independent variables are the categories of disease and occupation. Kruskal–Wallis test, Shapiro–Wilk test, and Brown–Forsythe (B–F) are used.ResultsThere are differences in mental sick leave lengths caused by substance use or other factors. In the case of mental illnesses attributable to drugs, differences in the sick leave duration among different working groups were not found. Considering mental disorders caused by other factors, there are differences in the sick leave duration among different working groups.ConclusionsThere is no evidence of longer sick leave in people diagnosed with mental disorder related to substance use. Differences in occupational categories do not relate to sick leave length.
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Affiliation(s)
- Beata Gavurova
- Faculty of Management and Economics, Tomas Bata University in Zlín, Zlín, Czechia
- *Correspondence: Beata Gavurova
| | - Miriama Tarhanicova
- Faculty of Mining, Ecology, Process Control and Geotechnologies, Technical University of Košice, Košice, Slovakia
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Sims SA, Pereira G, Preen D, Fatovich D, O'Donnell M. Young people with prior health service contacts have increased risk of repeated alcohol-related harm hospitalisations. Drug Alcohol Rev 2022; 41:1226-1235. [PMID: 35385585 DOI: 10.1111/dar.13467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 03/03/2022] [Accepted: 03/10/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION After a first alcohol-related hospitalisation in youth, subsequent hospitalisations may demonstrate an increased risk of further alcohol-related hospitalisations, but there is no existing data on this. METHODS A retrospective longitudinal study between July 1992 and June 2017 using linked hospital administrative data identified 23 464 Western Australian young people [9009 (38.4%) females and 14 455 (61.6%) males], aged 12-24 years hospitalised for at least one alcohol-related harm (ARH) episode of care. Cox regression was used to estimate hazard ratios (HR) between risk factors and repeated alcohol-related hospitalisation after the first discharge for ARH. RESULTS Of those admitted for an alcohol-related hospitalisation (n = 23 464), 21% (n = 4996) were readmitted for ARH. This high-risk sub-group comprised 46% (n = 16 017) of the total alcohol-related admissions (n = 34 485). After the first discharge for ARH, 16% (804) of people who experienced an alcohol-related readmission were readmitted within 1 month, and 51.8% (2589) were readmitted within 12 months. At increased risk of readmission were Aboriginal people and those with prior health service contacts occurring before their first alcohol-related hospitalisation, including illicit drug hospitalisations, mental health contacts and, in a sub-analysis, emergency department presentations. DISCUSSION AND CONCLUSIONS The probability of a repeated ARH hospitalisation was highest in the first month after initial discharge. There is a high-risk sub-group of young people more likely to have a repeat ARH hospitalisation. This represents an opportunity to provide interventions to those most at risk of repeated ARH.
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Affiliation(s)
- Scott A Sims
- School of Population and Global Health, University of Western Australia, Perth, Australia.,Developmental Pathways and Social Policy, Telethon Kids Institute, Perth, Australia
| | - Gavin Pereira
- Curtin School of Population Health, Curtin University, Perth, Australia.,enAble Institute, Curtin University, Perth, Australia.,Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - David Preen
- School of Population and Global Health, University of Western Australia, Perth, Australia
| | - Daniel Fatovich
- Department of Emergency Medicine, Royal Perth Hospital, Perth, Australia.,Emergency Medicine, University of Western Australia, Perth, Australia
| | - Melissa O'Donnell
- School of Population and Global Health, University of Western Australia, Perth, Australia.,Developmental Pathways and Social Policy, Telethon Kids Institute, Perth, Australia.,Australian Centre for Child Protection, University of South Australia, Adelaide, Australia
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