QUESTIONS:In the case of a road traffic crash, do sports utility vehicles (SUVs) and light truck vehicles (LTVs) cause more severe injuries to pedestrians and cyclists than passenger cars? Does any effect differ between adults and children? DESIGN:Systematic review and meta-analysis. DATA SOURCES:MEDLINE, TRID and Global Index Medicus were searched up to September 2024, with no restrictions by setting or language. INCLUSION CRITERIA:Eligible studies had to compare injury severity between pedestrians and/or cyclists hit by an SUV or LTV versus a passenger car. Only sources using real-world crash data were included. MAIN OUTCOME MEASURE:Injury severity, defined either as 'fatal versus non-fatal injury' or as 'killed or seriously injured (KSI) versus slight injury'. RESULTS:24 studies were included in the meta-analysis. The results were similar between pedestrians and cyclists. When combining pedestrians and cyclists, the pooled odds of KSI versus slight injury if hit by an SUV/LTV versus a passenger car were higher among adults/all-age samples by 1.24 (95% CI 1.15, 1.34) and higher among children by 1.28 (95% CI 1.19, 1.37). The odds of fatal versus non-fatal injury if hit by an SUV/LTV versus a passenger car increased among adults/all-age samples by 1.44 (95% CI 1.33, 1.56) and among children by 1.82 (95% CI 1.57, 2.11; p=0.006 for heterogeneity by age). CONCLUSION:In the case of a crash, SUVs and LTVs cause more severe injuries to pedestrians and cyclists than passenger cars. This effect is larger for fatalities than for KSIs, and the fatality effect is particularly large for children. PROSPERO registration number CRD42024597283.

Low traffic neighbourhoods (LTNs) are area-wide schemes that remove through motor traffic from residential streets. These schemes are controversial, and one focus for this controversy has been the potential for traffic diversion to increase air pollution on surrounding 'boundary roads'. In this study we estimate the air pollution changes and associated health impacts attributed to the implementation of five LTNs in London, UK. We did so by implementing a full-chain model covering changes in traffic-related emissions, air pollution, small-area level exposures, and health impacts across select outcomes. Model inputs included observed before-and-after changes in traffic volumes, traffic speeds and congestion. Inside LTNs, we found an average change of -0.157 μg/m3 for NO2 (equivalent to -0.87% in relative terms), and -0.0276 μg/m3 for PM2.5 (-0.33% in relative terms). In areas containing boundary roads, we found a mixture of positive and negative changes, with net effects slightly below zero (-0.18% for NO2, -0.06% for PM2.5). Thus, contrary to concerns, air quality did not deteriorate in boundary road areas on average. There was no evidence that the average improvement in air quality varied by area-level ethnic diversity or deprivation, but there was evidence that areas with the highest baseline pollution saw the smallest benefits. Overall, across LTNs and their surrounding areas, we estimated that the air quality improvements due to the LTNs translated into a -0.01% relative change in the number of deaths per year (-0.05% inside LTNs), and a -0.02% to -0.04% change in new cases of childhood asthma (-0.08% to -0.19% inside LTNs). We conclude that LTNs typically improve air quality in London but, at the current modest scale of implementation, their effect is small.

BACKGROUND:Between 2015 and 2024, 113 Low Traffic Neighbourhoods (LTNs) were implemented across Greater London, with 27 subsequently removed. We investigated their impacts on road traffic injuries inside LTNs and on 'boundary roads' immediately surrounding the LTNs. METHODS:We matched police-recorded injuries from STATS19 data to Ordnance Survey road links that were spatially intersected with LTNs/boundary roads. Conditional fixed-effects Poisson regression models used the number of injuries per road link per quarter of each year (January 2012 to June 2024) to test whether LTN implementation was associated with changes in injury rates. RESULTS:LTN implementation was associated with a 35% (95% CI 29% to 40%; p<0.001) decrease in all injuries and a 37% (95% CI 24% to 48%; p<0.001) decrease in people Killed or Seriously Injured (KSI). Injuries decreased across a range of casualty and LTN characteristics. However, there was evidence of a smaller benefit in LTNs implemented in Outer London since 2020. Following the removal of an LTN, injury numbers increased back to pre-intervention levels. On boundary roads, there was no evidence of a change in total injury numbers (estimate -2%, 95% CI -5% to +2%) or KSI injury numbers (estimate 0%, 95% CI -7% to +8%). This reflected decreased numbers of injuries on boundary roads for cyclists and motorcyclists, and no change for pedestrians and other motor vehicle users. CONCLUSION:LTNs in London reduced road traffic injuries among all road users inside the LTN areas, with no evidence of overall impact (and for cyclists and motorcyclists a benefit) on boundary roads.

At present, our understanding of trauma's complexity is underdeveloped, particularly with regard to intergenerational effects. In this paper, we review peer-reviewed literature on parental trauma and child well-being, focusing on mediating factors. We conducted a global systematic review of longitudinal, observational studies assessing mediators between a parent's traumatic exposure and their children's well-being. The primary outcome of the review was quantitative measures of child well-being (physical and psycho-social) assessed when the child was 18 years or under. We considered the following experiences as trauma exposures: intimate partner violence, rape, sexual assault, victimization during violent crime, childhood abuse, and exposure to direct, immediate threats to personal survival during war, political unrest, natural disasters, and sudden, critical injury/illness. Thirty-two studies met our inclusion criteria. The two most common mediator categories were caregiver mental health (n = 13) and parenting behavior (n = 10). Other studies measured aspects of the parent-child relationship (n = 9), maternal stress factors (n = 5), parental physical health (n = 2), and child-level factors (n = 6) as mediators. Almost all included studies (n = 28) detected a mediation effect. The majority of studies (n = 21) cited robust theoretical frameworks to support their mediator and outcome choices. Studies varied in quality, but most used appropriate, formal mediation analyses. Several study designs could be enhanced by methods to improve precision and reduce bias. Currently, there is little consistency in how similar constructs are measured between mediation studies. We did not locate any studies in low-income countries, and few studies examined aspects of family dynamics, physical health, environmental characteristics, or paternal factors.

This article explores the multiplicity of publics that are enacted in relation to infrastructures. We take the case of street lighting infrastructure in the UK in 2013/4, at a point when innovations in light emitting diode (LED) and smart technologies were making the infrastructuring of street lighting newly visible. Multifarious, emergent and recursive publics were variously enacted by lighting professionals, researchers, and publics themselves as part of this infrastructuring. We argue that these publics were constituted vis-à-vis other actors and entities and coalesced around configurations and attributions of knowledge, uncertainty and ignorance. “Supra-publics” indexed long-standing local knowledge gained by lighting professionals. “Occasioned publics” vis-à-vis technocratic expertise emerged when infrastructures became newly visible as lighting professionals (or researchers) consulted publics. “Citizen publics”, mobilized vis-à-vis governance, carefully marshalled experiential knowledge alongside newly acquired technical knowledge. These categories are neither comprehensive nor mutually exclusive, and their contours have shifted since our fieldwork as domains of knowledge and ignorance have changed. However, they are indicative of the multiplicity of publics that are part of lighting infrastructure in liberal states, and suggestive of ways in which publics are not stable entities, but rather in constant flux, as infrastructuring makes light work.

We used police-reported road crash data from Great Britain, 2004-2023, to examine whether being hit by a sports utility vehicle (SUV) is more dangerous for pedestrians and cyclists than being hit by a passenger car. In adjusted analyses, being hit by an SUV increased the odds of fatality by a modest amount in adults (odds ratio 1.14 (95% confidence interval 1.02, 1.28)). In children the odds of fatality increased considerably (odds ratio 1.77 (1.33, 2.35) in children aged 0-18 years), with particularly large effects in young children (odds ratio 3.09 (1.92, 4.97) in children aged 0-9 years). Vehicle weight and height showed strong, dose-response associations with injury severity, but vehicle length showed little association.

Intimate partner violence (IPV) is known to have detrimental effects on persons who directly experience this form of abuse. Emerging research also indicates that a parent’s experience of IPV may influence their children’s well-being through various intermediary pathways. However, there is still no established model to explain these mechanisms. This study is among the few that assess maternal mental health symptoms as potential mediators of the association between maternal IPV and child behavior. Using secondary data from a population-based, cross-sectional survey, we performed logistic regression analyses to assess the impact of lifetime maternal IPV exposure on child behavioral problems (withdrawal or aggression). We then applied generalized structural equation modeling to examine the mediating effects of both maternal depression and anxiety symptoms on this association. Over half (55%; 95% CI [48.3, 60.8]) of mothers had experienced IPV at some point, and 12.5% (95% CI [8.0, 19.1]) of children exhibited behavioral problems. Mothers exposed to IPV were almost three times as likely to report behavioral problems in their children compared to mothers with no history of IPV ( OR = 2.81; 95% CI [1.08, 7.33]). Furthermore, we found that both maternal depressive and anxiety symptoms partially mediated the relationship between maternal IPV exposure and child behavioral problems. These findings suggest that the impact of maternal IPV on child behavioral problems is partially explained by maternal mental health. Reducing IPV and improving maternal mental health through enhanced screening and community-based mental health initiatives may contribute to lowering the prevalence of child behavior problems in Trinidad and Tobago.

Background Paper questionnaires are more common in epidemiology than those administered online, but increasing Internet access may change this. Researchers planning to use a self-administered questionnaire should know whether response rates to questionnaires administered electronically differ to those of questionnaires administered by post. We analysed trials included in a recently updated Cochrane Review to answer this question. Methods We exported data of randomised controlled trials included in three comparisons in the Cochrane Review that had evaluated hypotheses relevant to our research objective and imported them into Stata for analysis. We pooled odds ratios for response in random effects meta-analyses. We explored causes of heterogeneity among study results using subgroups. We assessed evidence for reporting bias using Harbord's modified test for small-study effects. Results Twenty-seven trials (66,118 participants) evaluated the effect on response of an electronic questionnaire compared with postal. Results were heterogeneous (I-squared=98%). Synthesis of studies at low risk of bias indicates that response was increased (OR=1.43; 95% CI 1.08–1.89) using postal questionnaires. Ten trials (39,523 participants) evaluated the effect of providing a choice of mode (postal or electronic) compared to an electronic questionnaire only. Response was increased with a choice of mode (OR=1.63; 95% CI 1.18–2.26). Eight trials (20,909 participants) evaluated the effect of a choice of mode (electronic or postal) compared to a postal questionnaire only. There was no evidence for an effect on response (OR=0.94; 95% CI 0.86–1.02). Conclusions Postal questionnaires should be used in preference to, or offered in addition to, electronic modes.

Background Plans to phase out fossil fuel-powered internal combustion engine (ICE) vehicles and to replace these with electric and hybrid-electric (E-HE) vehicles represent a historic step to reduce air pollution and address the climate emergency. However, there are concerns that E-HE cars are more hazardous to pedestrians, due to being quieter. We investigated and compared injury risks to pedestrians from E-HE and ICE cars in urban and rural environments.Methods We conducted a cross-sectional study of pedestrians injured by cars or taxis in Great Britain. We estimated casualty rates per 100 million miles of travel by E-HE and ICE vehicles. Numerators (pedestrians) were extracted from STATS19 datasets. Denominators (car travel) were estimated by multiplying average annual mileage (using National Travel Survey datasets) by numbers of vehicles. We used Poisson regression to investigate modifying effects of environments where collisions occurred.Results During 2013-2017, casualty rates per 100 million miles were 5.16 (95% CI 4.92 to 5.42) for E-HE vehicles and 2.40 (95%CI 2.38 to 2.41) for ICE vehicles, indicating that collisions were twice as likely (RR 2.15; 95% CI 2.05 to 2.26) with E-HE vehicles. Poisson regression found no evidence that E-HE vehicles were more dangerous in rural environments (RR 0.91; 95% CI 0.74 to 1.11); but strong evidence that E-HE vehicles were three times more dangerous than ICE vehicles in urban environments (RR 2.97; 95% CI 2.41 to 3.7). Sensitivity analyses of missing data support main findings.Conclusion E-HE cars pose greater risk to pedestrians than ICE cars in urban environments. This risk must be mitigated as governments phase out petrol and diesel cars.

OBJECTIVE:To assess the cost-effectiveness of using cheaper-but-noisier outcome measures, such as a short questionnaire, for large simple clinical trials. BACKGROUND:To detect associations reliably, trials must avoid bias and random error. To reduce random error, we can increase the size of the trial and increase the accuracy of the outcome measurement process. However, with fixed resources, there is a trade-off between the number of participants a trial can enrol and the amount of information that can be collected on each participant during data collection. METHODS:To consider the effect on measurement error of using outcome scales with varying numbers of categories, we define and calculate the variance from categorisation that would be expected from using a category midpoint; define the analytic conditions under which such a measure is cost-effective; use meta-regression to estimate the impact of participant burden, defined as questionnaire length, on response rates; and develop an interactive web-app to allow researchers to explore the cost-effectiveness of using such a measure under plausible assumptions. RESULTS:An outcome scale with only a few categories greatly reduced the variance of non-measurement. For example, a scale with five categories reduced the variance of non-measurement by 96% for a uniform distribution. We show that a simple measure will be more cost-effective than a gold-standard measure if the relative increase in variance due to using it is less than the relative increase in cost from the gold standard, assuming it does not introduce bias in the measurement. We found an inverse power law relationship between participant burden and response rates such that a doubling the burden on participants reduces the response rate by around one third. Finally, we created an interactive web-app ( https://benjiwoolf.shinyapps.io/cheapbutnoisymeasures/ ) to allow exploration of when using a cheap-but-noisy measure will be more cost-effective using realistic parameters. CONCLUSION:Cheaper-but-noisier questionnaires containing just a few questions can be a cost-effective way of maximising power. However, their use requires a judgement on the trade-off between the potential increase in risk of information bias and the reduction in the potential of selection bias due to the expected higher response rates.

Background: The prevalence of genital chlamydia and gonorrhoea is higher in the 16–24 years age group than those in other age group. With users, we developed the theory-based safetxt intervention to reduce sexually transmitted infections. Objectives: To establish the effect of the safetxt intervention on the incidence of chlamydia/gonorrhoea infection at 1 year. Design: A parallel-group, individual-level, randomised superiority trial in which care providers and outcome assessors were blinded to allocation. Setting: Recruitment was from 92 UK sexual health clinics. Participants: Inclusion criteria were a positive chlamydia or gonorrhoea test result, diagnosis of non-specific urethritis or treatment started for chlamydia/gonorrhoea/non-specific urethritis in the last 2 weeks; owning a personal mobile phone; and being aged 16–24 years. Allocation: Remote computer-based randomisation with an automated link to the messaging system delivering intervention or control group messages. Intervention: The safetxt intervention was designed to reduce sexually transmitted infection by increasing partner notification, condom use and sexually transmitted infection testing before sex with new partners. It employed educational, enabling and incentivising content delivered by 42–79 text messages over 1 year, tailored according to type of infection, gender and sexuality. Comparator: A monthly message regarding trial participation. Main outcomes: The primary outcome was the incidence of chlamydia and gonorrhoea infection at 12 months, assessed using nucleic acid amplification tests. Secondary outcomes at 1 and 12 months included self-reported partner notification, condom use and sexually transmitted infection testing prior to sex with new partner(s). Results: Between 1 April 2016 and 23 November 2018, we assessed 20,476 people for eligibility and consented and randomised 6248 participants, allocating 3123 to the safetxt intervention and 3125 to the control. Primary outcome data were available for 4675 (74.8%) participants. The incidence of chlamydia/gonorrhoea infection was 22.2% (693/3123) in the intervention group and 20.3% (633/3125) in the control group (odds ratio 1.13, 95% confidence interval 0.98 to 1.31). There was no evidence of heterogeneity in any of the prespecified subgroups. Partner notification was 85.6% in the intervention group and 84.0% in the control group (odds ratio 1.14, 95% confidence interval 0.99 to 1.33). At 12 months, condom use at last sex was 33.8% in the intervention group and 31.2% in the control group (odds ratio 1.14, 95% confidence interval 1.01 to 1.28) and condom use at first sex with most recent new partner was 54.4% in the intervention group and 48.7% in the control group (odds ratio 1.27, 95% confidence interval 1.11 to 1.45). Testing before sex with a new partner was 39.5% in the intervention group and 40.9% in the control group (odds ratio 0.95, 95% confidence interval 0.82 to 1.10). Having two or more partners since joining the trial was 56.9% in the intervention group and 54.8% in the control group (odds ratio 1.11, 95% confidence interval 1.00 to 1.24) and having sex with someone new since joining the trial was 69.7% in the intervention group and 67.4% in the control group (odds ratio 1.13, 95% confidence interval 1.00 to 1.28). There were no differences in safety outcomes. Additional sensitivity and per-protocol analyses showed similar results. Limitations: Our understanding of the mechanism of action for the unanticipated effects is limited. Conclusions: The safetxt intervention did not reduce chlamydia and gonorrhoea infections, with slightly more infections in the intervention group. The intervention increased condom use but also increased the number of partners and new partners. Randomised controlled trials are essential for evaluating health communication interventions, which can have unanticipated effects. Future work: Randomised controlled trials evaluating novel interventions in this complex area are needed. Trial registration: This trial is registered as ISRCTN64390461. Funding: This project was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 11, No. 1. See the NIHR Journals Library website for further project information.

OBJECTIVE To quantify the effects of a series of text messages (safetxt) delivered in the community on incidence of chlamydia and gonorrhoea reinfection at one year in people aged 16-24 years. DESIGN Parallel group randomised controlled trial. SETTING 92 sexual health clinics in the United Kingdom. PARTICIPANTS People aged 16-24 years with a diagnosis of, or treatment for, chlamydia, gonorrhoea, or non-specific urethritis in the past two weeks who owned a mobile phone. INTERVENTIONS 3123 participants assigned to the safetxt intervention received a series of text messages to improve sex behaviours: four texts daily for days 1-3, one or two daily for days 4-28, two or three weekly for month 2, and 2-5 monthly for months 3-12. 3125 control participants received a monthly text message for one year asking for any change to postal or email address. It was hypothesised that safetxt would reduce the risk of chlamydia and gonorrhoea reinfection at one year by improving three key safer sex behaviours: partner notification at one month, condom use, and sexually transmitted infection testing before unprotected sex with a new partner. Care providers and outcome assessors were blind to allocation. MAIN OUTCOME MEASURES The primary outcome was the cumulative incidence of chlamydia or gonorrhoea reinfection at one year, assessed by nucleic acid amplification tests. Safety outcomes were self-reported road traffic incidents and partner violence. All analyses were by intention to treat. RESULTS 6248 of 20 476 people assessed for eligibility between 1 April 2016 and 23 November 2018 were randomised. Primary outcome data were available for 4675/6248 (74.8%). At one year, the cumulative incidence of chlamydia or gonorrhoea reinfection was 22.2% (693/3123) in the safetxt arm versus 20.3% (633/3125) in the control arm (odds ratio 1.13, 95% confidence interval 0.98 to 1.31). The number needed to harm was 64 (95% confidence interval number needed to benefit 334 to 8 to number needed to harm 24). The risk of road traffic incidents and partner violence was similar between the groups. CONCLUSIONS The safetxt intervention did not reduce chlamydia and gonorrhoea reinfections at one year in people aged 16-24 years. More reinfections occurred in the safetxt group. The results highlight the need for rigorous evaluation of health communication interventions.

Objectives This paper estimates the effect of changes in street lighting at night on levels of crime at street-level. Analyses investigate spatial and temporal displacement of crime into adjacent streets. Methods Offense data (burglaries, robberies, theft of and theft from vehicles, and violent crime) were obtained from Thames Valley Police, UK. Street lighting data (switching lights off at midnight, dimming, and white light) were obtained from local authorities. Monthly counts of crime at street-level were analyzed using a conditional fixed-effects Poisson regression model, adjusting for seasonal and temporal variation. Two sets of models analyzed: (1) changes in night-time crimes adjusting for changes in day-time crimes and (2) changes in crimes at all times of the day. Results Switching lights off at midnight was strongly associated with a reduction in night-time theft from vehicles relative to daytime (rate ratio RR 0.56; 0.41–0.78). Adjusted for changes in daytime, night-time theft from vehicles increased (RR 1.55; 1.14–2.11) in adjacent roads where street lighting remained unchanged. Conclusion Theft from vehicle offenses reduced in streets where street lighting was switched off at midnight but may have been displaced to better-lit adjacent streets. Relative to daytime, night-time theft from vehicle offenses reduced in streets with dimming while theft from vehicles at all times of the day increased, thus suggesting temporal displacement. These findings suggest that the absence of street lighting may prevent theft from vehicles, but there is a danger of offenses being temporally or spatially displaced.

Background Construction workers are 3-4 times more likely than other workers to die from accidents at work-however, in the developing world, the risks associated with construction work may be 6 times greater. India does not publish occupational injury statistics, and so little is known about construction workers injured. We aimed to use Indian police records to describe the epidemiology of construction site injuries in Delhi and to thus generate knowledge that may help to control the burden of injuries to construction workers in India and in other developing countries. Methods This was a cross-sectional analysis of accident records maintained by the Delhi Police. We included all construction workers reported to have been killed or injured in construction site accidents in Delhi during the period 2016-2018. We used multivariable logistic regression models to investigate associations between injury severity (fatal vs. non-fatal injury) and exposure variables whilst adjusting for a priori risk factors. We also estimated the number of Delhi construction workers in total and by trade to generate estimates of worker injury rates per 100,000 workers per year. Results There were 929 construction site accidents within the study period, in which 1,217 workers and children were reported to have sustained injuries: 356 (29%) were fatal and 861 (71%) were non-fatal. One-eighth of injuries were sustained by females. Most occurred in the Rainy season; most were sustained during the construction of buildings. The most frequent causes were the collapse of an old building, the collapse of a new building under construction, and electric shocks. Electricians were more likely than unskilled workers to suffer a fatal injury (adjOR 2.5; 95% CI: 0.87-6.97), and there were more electrical shocks than electricians injured. The odds of a fatal injury were statistically significantly lower in Central districts than in the less developed, peripheral districts. Conclusions Construction site injuries are an unintended health impact of urbanisation. Women undertake manual work alongside men on construction sites in Delhi, and many suffer injuries as a consequence: an eighth of the injuries were sustained by females. Children accompanying their working parents on construction sites are also at risk. Two main hazards to construction workers in Delhi were building collapses and electrical shocks. Electricians were over twice as likely as unskilled workers to suffer a fatal injury, and electrical work would appear to be undertaken by a multitude of occupations. As the global urban population increases over the coming decades, so too will the burden of injuries to construction workers. The introduction and enforcement of occupational safety, health, and working conditions laws in India and in other rapidly developing countries will be necessary to help to control this injury burden to construction workers.

Introduction: Increasing levels of active travel in the population brings many public health benefits, but may also change the risks of road injury for different road users. We examined changes in rates of pedestrian injuries resulting from collisions with pedal cycles and motor vehicles in England during 2005-2015, a period of increased cycling activity, and described the gender, age distribution and locations of pedestrians injured in collisions with pedal cycles and motor vehicles. Methods: Collisions data were obtained from police STATS19 datasets. We used two measures of cycle/motor vehicle use; miles per annum, and estimated average travel time, and assessed evidence for trends towards increase over time using Poisson regression analysis. Results: There were 3414 pedestrians injured in collisions with one or more pedal cycles in England during 2005-2015, 763 of whom were killed or seriously injured (KSI). This accounted for 1.3% of the total pedestrians KSI from all vehicles. Of those KSI in collisions with cycles, 62% were female; 42% over the age of 60; 26% were on the footway or verge and 24% were on a pedestrian crossing. There was a 6% (IRR 1.056; 95% CI 1.032-1.080, p < 0.001) annual increase in the pedestrian KSI rate per billion vehicle miles cycled in England over the time span. This increase was disproportionate to the increase in cycle use measured by vehicle miles or time spent cycling. Conclusions: Increases in cycling were associated with disproportionate increases in pedestrian injuries in collisions with pedal cycles in England, although these collisions remain a very small proportion of all road injury. Increased active travel is essential for meeting a range of public health goals, but needs to be planned for with consideration for potential impact on pedestrians, particularly older citizens.

Missing outcome data can lead to bias in the results of systematic reviews. One way to address missing outcome data is by requesting the data from the trial authors, but non-response is common. One way to potentially improve response rates is by sending study participants advance communication. During the update of a systematic review examining the effect of pre-notification on response rates, study authors needed to be contacted for further information. This study was nested within the systematic review by randomising authors to receive a notification of the upcoming request for information. The objective was to test if pre-notification increased response rates. The participants were study authors included in the systematic review, whose studies were at unclear risk of bias. The intervention was a pre-notification of the request for further information, sent 1 day before the request. The outcome was defined as the proportion of authors who responded to the request for information. Authors were randomised by simple randomisation. Thirty three authors were randomised to the pre-notification arm, and 42 were randomised to the control arm. Authors were blinded to the possibility of an alternative condition. All authors randomised were analysed. 14/33 (42.4%) authors in the pre-notification arm had returned responses to the questionnaire, and 18/42 (42.9%) in the control arm. There was no evidence of a difference between these groups (absolute difference = − 0.5, 95% CI (− 23.4 to 22.5%), p = 1). We received no complaints about receiving the pre-notification. This study’s results do not support the hypothesis that pre-notification increases response from study authors being contacted for a request for more information. However, the study has a low power, and the results may not generalise to other contexts, methods of administering a pre-notification, or study populations. Registration and protocol: This trial is not registered with any trial registry. However, the protocol was posted in advance on the Open Science Framework website and is available on the Open Science Framework website: DOI: https://doi.org/10.17605/OSF.IO/MSV2W or https://osf.io/msv2w/

Background: Study results can be badly affected by non-response. One way to potentially reduce non-response is by sending potential study participants advance communication. During the update of a systematic review examining the effect of pre-notification on response rates, a number of study authors needed to be contacted for further information. Objectives: To conduct an RCT to investigate the effect of pre-notification, nested within the request for further information for a systematic review. Methods: Study authors included in the systematic review, whose studies were at unclear risk of bias, and who were contactable, were randomly sent or not set a pre-notification email prior to being sent the request for further information email. Results: At the end of follow up, 14/33 (42.4%) authors in the pre-notification condition had returned responses to the questionnaire, and 18/42 (42.9%). There was not evidence of a difference between these groups. Conclusions: This study does not support the hypothesis that pre-notification does increase response from participants.

Background In India, the construction sector provides the main alternative to agricultural work - seasonal migration to and from construction work is widespread and construction work remains the second-largest employer of women in the country behind agriculture. Occupational injuries, which kill over 300,000 people annually, are a serious public health concern. However, data on construction site injuries to women are lacking, as India does not publish statistics on occupational injuries and illnesses. Our objectives were to: Estimate the number of women injured in construction site accidents in Delhi; and to estimate and compare the annual construction site injury rates per 100,000 workers of males and females in Delhi. Methods We conducted a two-sample capture-recapture study using data for accidents reported to the Delhi Police, Employee State Insurance Corporation (ESIC), and Commissioners of Workmen Compensation (CWC) of Delhi Government. The capture-recapture method has been used in epidemiology, to estimate morbidity and mortality using multiple, overlapping, but incomplete data sources. This study is based on the injuries reported from construction site accidents in Delhi in 2017. We linked the data from each of the data sources using the name, gender, and age of each injured person, the date and place of the accident, and the name of the employer. We used the Chapman estimator to estimate the total incidence of construction injuries in Delhi. Results We estimated that there was a total of 37 female construction site workers injured (17 fatal and 20 non-fatal) in Delhi in 2017. There was a total of 1043 male construction site workers injured (236 fatal and 807 non-fatal). FIRs ascertained two-thirds (68%) of all injuries to females but only one third (34%) of those to males. The annual construction site injury rate per 100,000 workers of females was 82.26 (95%CI: 57.92 to 113.39). The annual construction site injury rate per 100,000 workers of males was 146.5 (95%CI: 137.7 to 155.6). There was strong evidence (p = 0.001) that the overall construction site injury rate per 100,000 workers of females was about one half the rate of males [rate ratio 0.56 (95%CI: 0.40 to 0.78)]. There was no evidence (p = 0.601) that the rates of fatal injuries differed in males and females (rate ratio 1.14 (95%CI: 0.70 to 1.87). Conclusions This study is the first to estimate the incidence of injuries to female construction site workers in India. The overall injury rate of female construction workers was over half as great as the rate of males. This implies that female construction workers face a not insignificant risk. Hence, safety measures (e.g., personal protective equipment) that are appropriate and culturally acceptable to Indian women are needed.

Objective The Saudi government requires that all pilgrims receive a quadrivalent meningococcal vaccine at least 10 days before the Hajj. We conducted a study to determine the uptake of meningococcal vaccine and antibiotic use. We also investigated risk factors of meningococcal carriage and carriage of Neisseria meningitidis pathogenic serogroups A, C, W and Y. Methods A cross-sectional oropharyngeal carriage survey was conducted in 2973 Hajj pilgrims in September 2017. A real-time polymerase chain reaction (rt-PCR) assay was used to identify N. meningitidis from the oropharyngeal swabs. A questionnaire investigated potential risk factors for carriage of N. meningitidis. Results Two thousand two hundred forty nine oropharyngeal swabs were obtained. The overall prevalence of carriage of N. meningitidis was 4.6% (95% CI: 3.4%-6%). Carriage of pathogenic serogroups was not associated significantly with any of the meningococcal risk factors evaluated. 77% of pilgrims were vaccinated but 22.58 % said they were carrying unofficial vaccination cards. Conclusion Carriage of serogroups A, C, W and Y was not significantly associated with any of the risk factors investigated. Almost a quarter of pilgrims were unlikely to have been vaccinated, highlighting a need to strengthen compliance with the current policy of vaccination to prevent meningococcal disease outbreaks during and after the Hajj.

International Journal of Medicine and Public Health, Vol 11, Issue 1, Jan-Mar, 2021 1 Sajjan S Yadav1,*, Phil Edwards2, John Porter3 1Department of Expenditure, Ministry of Finance, Government of India, North Block, New Delhi, INDIA. 2Department of Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom. 3Department of Global Health and Development, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom.