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Article ; Online: Experiences and attitudes related to newborn feeding in central Uganda: A qualitative study.

Sewannonda, Andrew / Medel-Herrero, Alvaro / Nankabirwa, Victoria / Flaherman, Valerie J

2022 Volume 17, Issue 10, Page(s) e0274010

Abstract: Objective: Adequate infant nutrition is a critical cornerstone of population health, yet adherence to recommended breastfeeding practices is low in many countries in sub-Saharan Africa, including Uganda. This study aims to describe local attitudes, ... ...

Abstract	Objective: Adequate infant nutrition is a critical cornerstone of population health, yet adherence to recommended breastfeeding practices is low in many countries in sub-Saharan Africa, including Uganda. This study aims to describe local attitudes, experiences and beliefs related to nutrition in early infancy in Central Uganda. Design: We conducted 5 focus group discussions and 12 key informant interviews to gather information on local attitudes, experiences and beliefs related to feeding in early infancy. Setting: Urban areas of Central Uganda. Participants: Parents and healthcare and public health professionals. Results: Participants reported numerous concerns related to infant health including inadequate infant weight, premature birth, diarrhea, fever, gastrointestinal infection and malnutrition. Awareness of the infant health benefits of exclusive breastfeeding was prevalent but experienced as in balance with maternal factors that might lead to supplementation, including employment demands, physical appearance, pain, poverty and maternal health and malnutrition. Breastfeeding was highly valued, but use of unsafe breast milk supplements was common, including cow's milk, black tea, glucose water, fruit juice, millet, maize, rice, potatoes, soy, sorghum, egg yolk, fish and ghee. Expression of breast milk was viewed as not consonant with local culture. Conclusions: Participants were aware of the benefits of exclusive breastfeeding but described multiple barriers to achieving it. Supplementation with unsafe breastmilk supplements was considered to be more culturally consonant than milk expression and was reported to be the only affordable potential breast milk substitute for many families.
MeSH term(s)	Pregnancy ; Female ; Cattle ; Animals ; Ghee ; Uganda ; Malnutrition ; Tea ; Glucose ; Water ; Health Knowledge, Attitudes, Practice ; Mothers
Chemical Substances	Ghee ; Tea ; Glucose (IY9XDZ35W2) ; Water (059QF0KO0R)
Language	English
Publishing date	2022-10-19
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0274010
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Advances in diagnostic codes to document sexual assault in health care service.

Medel-Herrero, Alvaro / Smiley-Jewell, Suzette / Shumway, Martha / Reidy, Dennis E / Bonomi, Amy

Health services research

2022 Volume 58, Issue 4, Page(s) 807–816

Abstract: Objective: To explore trends in documented sexual abuse/assault (SA) related episodes in California hospitals and emergency departments (ED), including the impact of a change in health care service reporting codification (from ICD-9-CM to ICD-10-CM) ... ...

Abstract	Objective: To explore trends in documented sexual abuse/assault (SA) related episodes in California hospitals and emergency departments (ED), including the impact of a change in health care service reporting codification (from ICD-9-CM to ICD-10-CM) that more clearly defined SA in October 2015. Data sources: Hospital and ED data were drawn from California's Office of Statewide Health Planning and Development (OSHPD). Study design: Descriptive and trend analyses of SA-related hospital and ED records (including patients' demographic information) were conducted to determine whether changes in ICD codification had an impact on documented SA-related episodes. Data collection: All SA-related episodes (ICD-9-CM codes 995.83, 995.53; ICD-10-CM codes T74.21-T74.22, T76.21-T76.22) in California hospitals and EDs for the last decade of available data (2008-2017) were analyzed (n = 20,215). Principal findings: An abrupt increase in documented SA episodes in hospitals and EDs began in October 2015, when specific ICD10 codes for suspected cases of SA were created. Documented SA-related episodes doubled in 1 month (164 vs. 385 episodes in September 2015 and October 2015, respectively). More than half (58.2%) of all SA-related episodes documented in Oct 2015 were coded as suspicious. The number of documented SA-related episodes continued increasing to the end of the time series (December 2017). Overall, the annual number of documented SA-related episodes increased by over 700% in only 4 years (900 vs. 6441 in 2013 and 2017, respectively), suggesting high rates of prior under-reporting and the need to introduce the new codes. African Americans were disproportionally impacted; however, the highest increases in age-adjusted rates between the ICD-9-CM and the ICD-10 codification period were found among the White population (2.46 vs. 16.53 per 100,000 inhabitants). Conclusions: SA episodes in the clinical population have been underestimated for many decades. Identifying SA victims and measuring SA-related health care utilization is a real challenge that needs further investigation.
MeSH term(s)	Humans ; Emergency Service, Hospital ; Patient Acceptance of Health Care ; Hospitals ; Time Factors ; Sex Offenses
Language	English
Publishing date	2022-07-21
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	410435-3
ISSN	1475-6773 ; 0017-9124
ISSN (online)	1475-6773
ISSN	0017-9124
DOI	10.1111/1475-6773.14021
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Article ; Online: Slowdown in the Decline of Tuberculosis Rates in California, 2000-2016.

Medel-Herrero, Alvaro / Martínez-López, Beatriz

American journal of public health

2018 Volume 109, Issue 2, Page(s) 306–312

Abstract: Objectives: To determine the impact of the 2007-2009 economic crisis on tuberculosis (TB) trends among California residents.: Methods: We analyzed available data from 4 different population-representative data sets. We used time charts, trend lines, ... ...

Abstract	Objectives: To determine the impact of the 2007-2009 economic crisis on tuberculosis (TB) trends among California residents. Methods: We analyzed available data from 4 different population-representative data sets. We used time charts, trend lines, and change-point detection tests during 2000 to 2016 to describe TB trends in California. Results: We found statistically significant changes in California TB trends with the time of the onset of the economic downturn based on age-adjusted TB case rates and TB mortality rates, crude rate of TB hospitalizations, and self-reported TB. Change on TB incidence was especially apparent among racial/ethnic minority groups. Conclusions: To our knowledge, changes in TB trends in the United States matching in time with the 2007-2009 economic crisis have not been previously reported. This study identified a slowdown in the decline of TB rates by 2007 to 2009 and provides new knowledge on TB trends that can be used to achieve California's goal of eliminating TB by 2040 and in the prevention and control of TB in the United States.
MeSH term(s)	California/epidemiology ; Hospitalization/statistics & numerical data ; Humans ; Incidence ; Prevalence ; Retrospective Studies ; Self Report/statistics & numerical data ; Tuberculosis/epidemiology ; Tuberculosis/mortality ; Tuberculosis/prevention & control
Language	English
Publishing date	2018-12-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	121100-6
ISSN	1541-0048 ; 0090-0036 ; 0002-9572
ISSN (online)	1541-0048
ISSN	0090-0036 ; 0002-9572
DOI	10.2105/AJPH.2018.304816
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Article ; Online: The impact of the Great Recession on California domestic violence events, and related hospitalizations and emergency service visits.

Medel-Herrero, Alvaro / Shumway, Martha / Smiley-Jewell, Suzette / Bonomi, Amy / Reidy, Dennis

Preventive medicine

2020 Volume 139, Page(s) 106186

Abstract: Objective: Explore the impact of the Great Recession on domestic violence (DV) related hospitalizations and emergency department (ED) visits in California.: Methods: Hospital and ED data were drawn from California's Office of Statewide Health ... ...

Abstract	Objective: Explore the impact of the Great Recession on domestic violence (DV) related hospitalizations and emergency department (ED) visits in California. Methods: Hospital and ED data were drawn from California's Office of Statewide Health Planning and Development (OSHPD). DV-related hospitalizations and ED visits in California were analyzed between January 2000 and September 2015 (53,596), along with total medical costs. Time series were divided into pre-recession (Jan 2000-Nov 2007) and recession/post-recession (Dec 2007-Sept 2015) periods. Results: The medical cost of DV-related hospitalizations alone was estimated as $1,136,165,861. A dramatic increase in DV episodes was found potentially associated with the Great Recession. The number of ED visits per month tripled from pre- to post-recession (104.9 vs. 290.6), along with an increased number of hospitalizations (77.1 vs. 95.6); African Americans and Native Americans were disproportionally impacted. In addition, psychiatric comorbidities, severe DV episodes, in-hospital mortality and charge per hospitalization escalated. The rise in DV hospitalizations and ED visits beginning in December 2007 was mainly attributable to physical abuse episodes in adults; minors had no change in DV trends. Discussion: Recessions are frequent in modern economies and are repeated cyclically. Our study provides critical information on the effects of the 2007 financial crisis on DV-related healthcare service utilization in California. Given the current financial crisis associated with COVID-19, which expert predict could extend for years, the results from this study shine a spotlight on the importance of DV-related screening, prevention and response.
MeSH term(s)	Adolescent ; Adult ; Aged ; California ; Child ; Child, Preschool ; Domestic Violence/economics ; Domestic Violence/statistics & numerical data ; Economic Recession ; Emergency Service, Hospital/economics ; Emergency Service, Hospital/statistics & numerical data ; Facilities and Services Utilization ; Female ; Health Care Costs ; Hospitalization/economics ; Hospitalization/statistics & numerical data ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Retrospective Studies ; Young Adult
Keywords	covid19
Language	English
Publishing date	2020-06-25
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	184600-0
ISSN	1096-0260 ; 0091-7435
ISSN (online)	1096-0260
ISSN	0091-7435
DOI	10.1016/j.ypmed.2020.106186
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Article ; Online: Changing SNAP-Participation Trends Among Farmworker Households in the U.S., 2003-2012.

Medel-Herrero, Alvaro / Leigh, J Paul

Journal of immigrant and minority health

2017 Volume 20, Issue 3, Page(s) 507–516

Abstract: We investigated Supplemental Nutrition Assistance Program (SNAP) participation among citizen, documented and undocumented immigrant hired crop farmworkers for ten recent years. We analyzed population representative data from the National Agricultural ... ...

Abstract	We investigated Supplemental Nutrition Assistance Program (SNAP) participation among citizen, documented and undocumented immigrant hired crop farmworkers for ten recent years. We analyzed population representative data from the National Agricultural Workers Survey for 2003-2012 (N = 18,243 households). Time-chart, simple mean differences, and logistic regressions described farmworker household participation in SNAP. The 2008 financial crisis almost doubled SNAP-participation by agriculture households (6.5% in 2003-2007 vs. 11.3% in 2008-2012). The increasing SNAP-participation was found for citizen, documented and undocumented immigrant households. We found low participation among documented (OR 0.67, 95% CI 0.56-0.8) and undocumented immigrants (OR 0.63, 95% CI 0.54-0.74) compared to citizens. Low odds ratios (OR 0.70, 95% CI 0.55-0.89) were found for Hispanic-citizens as compared with non-Hispanic white-citizens. Our results may help inform the debate surrounding the effects of the financial crisis on SNAP-participation and on differences in participation among citizens, immigrants, Hispanics and non-Hispanics, the latter suggesting ethnic farmworker disparities in SNAP-participation.
MeSH term(s)	Adolescent ; Adult ; Cross-Sectional Studies ; Family Characteristics ; Farmers ; Female ; Food Assistance/trends ; Food Supply ; Humans ; Logistic Models ; Male ; Middle Aged ; Nutrition Surveys ; Undocumented Immigrants ; Young Adult
Language	English
Publishing date	2017-06-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	2220162-2
ISSN	1557-1920 ; 1557-1912
ISSN (online)	1557-1920
ISSN	1557-1912
DOI	10.1007/s10903-017-0600-x
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Article ; Online: The impact of the 2008 economic crisis on the increasing number of young psychiatric inpatients.

Medel-Herrero, Alvaro / Gomez-Beneyto, Manuel

Revista de psiquiatria y salud mental

2017 Volume 12, Issue 1, Page(s) 28–36

Abstract: Background: Little is published about the impact of the 2008 economic crisis on mental health services in Spain.: Method: An interrupted time series analysis was conducted to investigate a potential short-term association between the 2008 economic ... ...

Title translation	Impacto de la crisis económica del 2008 en el número de jóvenes hospitalizados por patología psiquiátrica.
Abstract	Background: Little is published about the impact of the 2008 economic crisis on mental health services in Spain. Method: An interrupted time series analysis was conducted to investigate a potential short-term association between the 2008 economic crisis and the number of psychiatric hospital admissions. The timing of the intervention (April 2008) was based on observed changes in Gross Domestic Product (GDP). Data on 1,152,880 psychiatric inpatients from the national Hospital Morbidity Survey, 69 months before and after the onset of the economic crisis (April 2008), were analyzed. Results: Age-adjusted psychiatric (ICD9 290-319) hospital discharge rates significantly increased from April 2008, matching the onset of the crisis, especially for inpatients aged 15-24 years old and to a less extend for inpatients aged 25-34 years old. Other age groups were not affected. There was a significant increase in diagnoses for disturbance of conduct and emotions, depression, neurotic and personality disorders and alcohol and drug disorders; however, diagnoses for mental retardation and organic psychosis for 15-34 years old inpatients were unaffected. Conclusions: Psychiatric hospital admissions abruptly increased in April 2008, coinciding with the onset of the economic crisis. We identified age groups and diagnoses affected. Increased hospitalizations were found only at the age-ranges most affected by the rise in unemployment. The diagnoses affected were those most sensitive to environmental changes.
MeSH term(s)	Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Economic Recession ; Female ; Hospitals, Psychiatric/trends ; Humans ; Male ; Mental Disorders/economics ; Mental Disorders/epidemiology ; Mental Disorders/etiology ; Middle Aged ; Patient Admission/trends ; Risk Factors ; Spain/epidemiology ; Unemployment/psychology ; Unemployment/trends ; Young Adult
Language	Spanish
Publishing date	2017-11-22
Publishing country	Spain
Document type	Journal Article
ISSN	2173-5050
ISSN (online)	2173-5050
DOI	10.1016/j.rpsm.2017.10.002
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Article: The Expanding Burden of Acute Kidney Injury in California: Impact of the Epidemic of Diabetes on Kidney Injury Hospital Admissions.

Medel-Herrero, Alvaro / Mitchell, Diane / Moyce, Sally / Udaltsova, Irina / Schenker, Mark

Nephrology nursing journal : journal of the American Nephrology Nurses' Association

2019 Volume 46, Issue 6, Page(s) 629–640

Abstract: Reducing the growing burden of acute kidney injury (AKI) is a real challenge. This article explores admissions and emergency visits of patients with AKI in California between 2005 and 2015. Data were drawn from California's Office of Statewide Health ... ...

Abstract	Reducing the growing burden of acute kidney injury (AKI) is a real challenge. This article explores admissions and emergency visits of patients with AKI in California between 2005 and 2015. Data were drawn from California's Office of Statewide Health Planning and Development (OSHPD) hospital dataset. Trend analyses, including comorbidities and spatiotemporal analysis, were conducted. AKI hospital episodes almost doubled between 2005 and 2015 (25,495 vs. 48,845, respectively); the growing trend was largely attributable to an increasing number of patients with co-existing CKD and diabetes or hypertension (2,511 vs. 25,098 in 2005 and 2015, respectively). We also found an increasingly positive spatiotemporal correlation between diabetes prevalence and AKI hospitalization rate over time. Based on results of this study, we identified modifiable targets to reduce the growing number of AKI episodes and the potential escalating health care costs.
MeSH term(s)	Acute Kidney Injury/complications ; Acute Kidney Injury/epidemiology ; California/epidemiology ; Diabetes Complications/epidemiology ; Diabetes Mellitus ; Hospitalization/statistics & numerical data ; Humans ; Retrospective Studies ; Risk Factors
Language	English
Publishing date	2019-12-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	2008177-7
ISSN	1526-744X ; 8750-0779
ISSN	1526-744X ; 8750-0779
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Article ; Online: Participation in the Women, Infants, and Children (WIC) Program as Reported by Documented and Undocumented Farm Worker Adults in the Households.

Leigh, J Paul / Medel-Herrero, Alvaro

Journal of agromedicine

2015 Volume 20, Issue 4, Page(s) 409–418

Abstract: Debate surrounds the provision of Women, Infants, and Children (WIC) benefits to undocumented immigrants. Few studies are available to estimate use of WIC services by documented and undocumented households using nationally representative data. The ... ...

Abstract	Debate surrounds the provision of Women, Infants, and Children (WIC) benefits to undocumented immigrants. Few studies are available to estimate use of WIC services by documented and undocumented households using nationally representative data. The authors analyzed data from the National Agricultural Workers Survey (NAWS) annual cross-sections from 1993 through 2009 (N = 40,896 person-years). Household documentation status is defined by the status of the adults in the household, not children. Simple mean differences, logistic regressions, and time charts described household participation in WIC over 2-year intervals. Without adjustments for covariates, 10.7% of undocumented farm workers' households and 12.4% of documented households received WIC benefits, yielding an odds ratio of 0.84 (95% confidence interval [CI]: 0.76-0.94). Logistic regressions revealed that for the same number of children in the household, participation by undocumented persons was higher than participation by documented persons. Time charts and logistic regressions with interaction terms showed a stronger correspondence between participation in WIC and number of children <6 years old in undocumented households than documented households. Undocumented farm workers' households were only a little less likely to participate in WIC than documented farm workers' households, and undocumented households' participation was especially responsive to the presence of children. These results are consistent with the legal requirements for WIC participation, which do not distinguish between documented and undocumented households. These results may be helpful in the debate surrounding the effects of undocumented workers on WIC participation and costs.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child, Preschool ; Family Characteristics ; Farmers/statistics & numerical data ; Female ; Government Programs ; Humans ; Infant ; Infant, Newborn ; Male ; Maternal-Child Health Services/utilization ; Middle Aged ; Public Assistance/utilization ; Undocumented Immigrants/statistics & numerical data ; United States/epidemiology ; Young Adult
Language	English
Publishing date	2015
Publishing country	England
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	1289325-0
ISSN	1545-0813 ; 1059-924X
ISSN (online)	1545-0813
ISSN	1059-924X
DOI	10.1080/1059924X.2015.1074973
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Article: The impact of the Great Recession on California domestic violence events, and related hospitalizations and emergency service visits

Medel-Herrero, Alvaro / Shumway, Martha / Smiley-Jewell, Suzette / Bonomi, Amy / Reidy, Dennis

Prev Med

Abstract: OBJECTIVE: Explore the impact of the Great Recession on domestic violence (DV) related hospitalizations and emergency department (ED) visits in California. METHODS: Hospital and ED data were drawn from California's Office of Statewide Health Planning and ...

Abstract	OBJECTIVE: Explore the impact of the Great Recession on domestic violence (DV) related hospitalizations and emergency department (ED) visits in California. METHODS: Hospital and ED data were drawn from California's Office of Statewide Health Planning and Development (OSHPD). DV-related hospitalizations and ED visits in California were analyzed between January 2000 and September 2015 (53,596), along with total medical costs. Time series were divided into pre-recession (Jan 2000-Nov 2007) and recession/post-recession (Dec 2007-Sept 2015) periods. RESULTS: The medical cost of DV-related hospitalizations alone was estimated as $1,136,165,861. A dramatic increase in DV episodes was found potentially associated with the Great Recession. The number of ED visits per month tripled from pre- to post-recession (104.9 vs. 290.6), along with an increased number of hospitalizations (77.1 vs. 95.6); African Americans and Native Americans were disproportionally impacted. In addition, psychiatric comorbidities, severe DV episodes, in-hospital mortality and charge per hospitalization escalated. The rise in DV hospitalizations and ED visits beginning in December 2007 was mainly attributable to physical abuse episodes in adults; minors had no change in DV trends. DISCUSSION: Recessions are frequent in modern economies and are repeated cyclically. Our study provides critical information on the effects of the 2007 financial crisis on DV-related healthcare service utilization in California. Given the current financial crisis associated with COVID-19, which expert predict could extend for years, the results from this study shine a spotlight on the importance of DV-related screening, prevention and response.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #613708
Database	COVID19

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Article ; Online: Newborn weight change and predictors of underweight in the neonatal period in Guinea-Bissau, Nepal, Pakistan and Uganda.

Flaherman, Valerie J / Ginsburg, Amy S / Nankabirwa, Victoria / Braima da Sa, Augusto / Medel-Herrero, Alvaro / Schaefer, Eric / Dongol, Srijana / Shrestha, Akina / Nisar, Imran / Altaf, Muddassir / Liaquat, Khushboo / Baloch, Benazir / Rahman, Najeeb / Shafiq, Yasir / Ariff, Shabina / Jehan, Fyezah / Roberts, Susan B

Maternal & child nutrition

2022 Volume 18, Issue 4, Page(s) e13396

Abstract: In low- and middle-income countries (LMIC), growth impairment is common; however, the trajectory of growth over the course of the first month has not been well characterised. To describe newborn growth trajectory and predictors of growth impairment, we ... ...

Abstract	In low- and middle-income countries (LMIC), growth impairment is common; however, the trajectory of growth over the course of the first month has not been well characterised. To describe newborn growth trajectory and predictors of growth impairment, we assessed growth frequently over the first 30 days among infants born ≥2000 g in Guinea-Bissau, Nepal, Pakistan and Uganda. In this cohort of 741 infants, the mean birth weight was 3036 ± 424 g. For 721 (98%) infants, weight loss occurred for a median of 2 days (interquartile range, 1-4) following birth until weight nadir was reached 5.9 ± 4.3% below birth weight. At 30 days of age, the mean weight was 3934 ± 592 g. The prevalence of being underweight at 30 days ranged from 5% in Uganda to 31% in Pakistan. Of those underweight at 30 days of age, 56 (59%) had not been low birth weight (LBW), and 48 (50%) had reached weight nadir subsequent to 4 days of age. Male sex (relative risk [RR] 2.73 [1.58, 3.57]), LBW (RR 6.41 [4.67, 8.81]), maternal primiparity (1.74 [1.20, 2.51]) and reaching weight nadir subsequent to 4 days of age (RR 5.03 [3.46, 7.31]) were highly predictive of being underweight at 30 days of age. In this LMIC cohort, country of birth, male sex, LBW and maternal primiparity increased the risk of impaired growth, as did the modifiable factor of delayed initiation of growth. Interventions tailored to infants with modifiable risk factors could reduce the burden of growth impairment in LMIC.
MeSH term(s)	Birth Weight ; Female ; Guinea-Bissau/epidemiology ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Nepal/epidemiology ; Pakistan/epidemiology ; Thinness/epidemiology ; Uganda/epidemiology
Language	English
Publishing date	2022-07-12
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2175105-5
ISSN	1740-8709 ; 1740-8695
ISSN (online)	1740-8709
ISSN	1740-8695
DOI	10.1111/mcn.13396
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