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McClure, Roderick

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McClure

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Roderick

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McClure, Roderick

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    Impact of participant attrition on child injury outcome estimates: a longitudinal birth cohort study in Australia
    (BMJ Publishing Group, 2017) Cameron, Cate M; Osborne, Jodie M; Spinks, Anneliese B; Davey, Tamzyn M; Sipe, Neil; McClure, Roderick
    Background: Longitudinal research is subject to participant attrition. Systemic differences between retained participants and those lost to attrition potentially bias prevalence of outcomes, as well as exposure-outcome associations. This study examines the impact of attrition on the prevalence of child injury outcomes and the association between sociodemographic factors and child injury. Methods: Participants were recruited as part of the Environments for Healthy Living (EFHL) birth cohort study. Baseline data were drawn from maternal surveys. Child injury outcome data were extracted from hospital records, 2006–2013. Participant attrition status was assessed up to 2014. Rates of injury-related episodes of care were calculated, taking into account exposure time and Poisson regression was performed to estimate exposure-outcome associations. Results: Of the 2222 participating families, 799 families (36.0%) had complete follow-up data. Those with incomplete data included 137 (6.2%) who withdrew, 308 (13.8%) were lost to follow-up and 978 families (44.0%) who were partial/non-responders. Families of lower socioeconomic status were less likely to have complete follow-up data (p<0.05). Systematic differences in attrition did not result in differential child injury outcomes or significant differences between the attrition and non-attrition groups in risk factor effect estimates. Participants who withdrew were the only group to demonstrate differences in child injury outcomes. Conclusion: This research suggests that even with considerable attrition, if the proportion of participants who withdraw is minimal, overall attrition is unlikely to affect the population prevalence estimate of child injury or measures of association between sociodemographic factors and child injury.
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    Injury talk: spontaneous parent–child conversations in the aftermath of a potentially traumatic event
    (BMJ Publishing Group, 2017) Alisic, Eva; Gunaratnam, Shaminka; Barrett, Anna; Conroy, Rowena; Jowett, Helen; Bressan, Silvia; Babl, Franz E; McClure, Roderick; Anderson, Vicki; Mehl, Matthias R
    Background: While talking about traumatic experiences is considered central to psychological recovery, little is known about how these conversations occur in daily life. Objective: We investigated spontaneous injury talk among parents and children in the aftermath of a child’s hospitalisation due to physical trauma, and its relationship with children’s socioemotional functioning. Methods: In a prospective naturalistic observation study, we audio-sampled the daily life of 71 families with the Electronically Activated Recorder after their child (3–16 years old) was discharged from hospital. We collected close to 20 000 snippets of audio information, which were double-coded for conversation characteristics, and measured children’s socioemotional functioning with the Strengths and Difficulties Questionnaire (SDQ) at 6 weeks and 3 months postinjury. Findings: The children were involved in injury talk for, on average, 46 min/day, 9 min of which referred to emotions. Children had significantly more injury conversations with their mothers than with their fathers. The tone of injury conversations was significantly more positive than that of non-injury conversations. More direct injury talk was associated with fewer problems on the emotion subscale of the SDQ at 3 months. Other associations between aspects of injury talk and children’s socioemotional functioning were mostly non-significant, although they appeared to be stronger at 3 months than at 6 weeks. Conclusions: Families spontaneously talked about the injury and associated issues for about the same amount of time per day as a therapist might within a session (a ‘therapy hour’). Clinical implications Making full use of naturally occurring injury talk may be a valuable direction for parent and family-focused postinjury interventions. However, the study design prevents causal inference, and further exploration is warranted.